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U. S. DEPARTMENT OF LABOR Employees Compensation Appeals Board In the Matter of ELIZABETH BOSWELL and DEPARTMENT OF THE AIR FORCE, PATRICK AIR FORCE BASE, Fla. Docket No. 952962; Submitted on the
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Start by entering your personal information, such as your full name, address, and contact details.
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Proceed to fill in the required information regarding your previous employment history, including the names of your previous employers, dates of employment, and job titles.
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Provide details about your wages and earnings, such as the amount you were paid and the frequency of payment (weekly, bi-weekly, etc.).
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Indicate whether you received any fringe benefits or allowances from your previous employer, specifying the type and value of each benefit.
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If applicable, mention any deductions that were made from your wages, such as taxes or other withholdings.
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Sign and date the form once you have completed all the necessary sections.
Who needs 95-2962doc - dol:
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Individuals who are seeking to file a claim or report to the Department of Labor (DOL) regarding their previous employment.
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Anyone who wants to provide detailed information about their wages, employment history, and fringe benefits for the purpose of a complaint or investigation by the DOL.
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Employees who may require assistance or guidance in understanding their rights and obligations under labor laws and regulations.
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