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Workers Compensation Claim Form (DWC 1) & Notice of Potential Eligibility Formulation de Reclamo de Compensaci n de Trabajadores (DWC 1) y Notification n de Possible Elegibilidad If you are injured

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1. Begin by entering your personal details such as your full name, date of birth, and contact information. This is vital for the recipient of the form to identify and reach out to you if needed.
2. Next, provide any required identification information, such as your social security number or driver's license number. This is commonly needed for verification purposes or to comply with legal requirements.
3. Specify your current address, including the street, city, state, and zip code. This allows the form recipient to have accurate information for correspondence or location-specific services.
4. If applicable, state your occupation or current employment details. This information may be necessary depending on the purpose of the form, such as employment applications or government-related documents.
5. Some forms might require you to provide financial information, such as your income, assets, or liabilities. This assists the form recipient in assessing your financial situation or determining eligibility for certain services or benefits.
6. Follow any specific instructions or guidelines regarding the form's purpose. For instance, if the form pertains to medical history or insurance claims, ensure you provide accurate and detailed information to facilitate proper assessment or coverage.
7. Review the filled-out form for accuracy and completeness before submitting. Double-check that all the required fields are filled, including any mandatory signatures or dates.

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