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North Carolina Industrial CommissionITEMIZED STATEMENT OF CHARGES FOR TRAVEL
The Use of This Form Is Required Under the Provisions of the Workers\' Compensation Employees NameEmployer\'s NameAddressEmployers
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How to fill out statement of days worked

How to fill out statement of days worked
01
Gather all necessary documents such as timesheets or work logs
02
Start by filling out your name, employee ID, and the date range for which you are reporting
03
Record the number of days worked during each week within the specified date range
04
Double check your entries for accuracy and completeness
05
Sign and date the statement before submitting it to the appropriate party
Who needs statement of days worked?
01
Employees who are required to report their days worked for payroll or attendance purposes
02
Employers who need to keep track of their employees' work hours for compliance or monitoring
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What is statement of days worked?
Statement of days worked is a document that records the number of days an individual has worked in a specific timeframe.
Who is required to file statement of days worked?
Employers are required to file statement of days worked for their employees.
How to fill out statement of days worked?
To fill out statement of days worked, you need to provide information such as employee's name, number of days worked, and dates worked.
What is the purpose of statement of days worked?
The purpose of statement of days worked is to track and report the number of days worked by employees for tax and labor compliance purposes.
What information must be reported on statement of days worked?
Information such as employee's name, number of days worked, dates worked, and employer's information must be reported on statement of days worked.
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