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Please TYPE or PRINT IN INK Rev. 1252016State of Connecticut
Workers Compensation Commission WCC File #Notice of Claim for Compensation30CDate filed in District(Employee to Commissioner and to Employer)This
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To fill out employee to commissioner, follow the steps below:
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Who needs employee to commissioner and?
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Employers or organizations that need to appoint a commissioner for their employees.
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What is employee to commissioner and?
Employee to commissioner and is a report that employers must submit to the commissioner providing information about their employees.
Who is required to file employee to commissioner and?
Employers are required to file employee to commissioner and.
How to fill out employee to commissioner and?
Employee to commissioner and can be filled out online or through paper forms provided by the commissioner.
What is the purpose of employee to commissioner and?
The purpose of employee to commissioner and is to provide accurate information about employees for tax and other purposes.
What information must be reported on employee to commissioner and?
Information such as employee's name, social security number, wages, and taxes withheld must be reported on employee to commissioner and.
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