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Get the free www.dir.ca.govdwcforms-MileageDWC Forms - California Department of Industrial Relations

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Instructions for mileage form: New form effective 1/1/2022. Old form will be returned if used for January 2022 and after, delaying your reimbursement. PO's must be in place before traveling (mileage
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How to fill out wwwdircagovdwcforms-mileagedwc forms - california

01
Access the www.dircagovdwcforms website
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Select the appropriate DWC form for mileage reimbursement
03
Fill out the form with accurate information including date of travel, starting location, destination, and total miles traveled
04
Sign and date the form
05
Submit the completed form to the relevant party for reimbursement

Who needs wwwdircagovdwcforms-mileagedwc forms - california?

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Employees who have traveled for work-related purposes in California and are seeking reimbursement for mileage expenses
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This form is used to report mileage for workers' compensation claims in California.
Employers and insurance companies are required to file this form.
The form should be filled out accurately and completely with all required information regarding mileage for workers' compensation claims.
The purpose of this form is to accurately report mileage related to workers' compensation claims in California.
Information regarding mileage for workers' compensation claims must be reported on this form.
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