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Reset Form Print Form State of California Division of Workers' Compensation SUPPLEMENTAL JOB DISPLACEMENT NONTRANSFERABLE TRAINING VOUCHER FORM FOR INJURIES OCCURRING BETWEEN 1/1/04-12/31/12, INCLUSIVE
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How to fill out supplemental job displacement nontransferable

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01
To fill out the supplemental job displacement nontransferable form, start by gathering all the necessary information and documentation related to your employment and job displacement situation.
02
Begin by providing your personal details, including your name, address, contact information, and social security number, as requested in the form.
03
The form will likely ask you to provide information about your previous employer, such as the company's name, address, and contact information. Make sure to accurately fill out these details.
04
You may also need to provide details about your job position, including your job title, duties, and responsibilities. If you have any official job descriptions or employment contracts, it might be helpful to refer to them while filling out this section.
05
Carefully read and answer any questions or prompts related to your job displacement. This might include explaining the reasons why you are no longer employed, whether you were laid off, terminated, or if your position was eliminated. Be as detailed and accurate as possible.
06
If there is a section related to any benefits or compensation offered by your previous employer, make sure to carefully review and provide accurate information. This could include any severance packages, retirement benefits, or other financial assistance you received as a result of your job displacement.
07
It is important to read and understand any terms and conditions associated with the supplemental job displacement nontransferable benefits. Make sure to provide any additional information or documentation required to demonstrate your eligibility for these benefits.

Who needs supplemental job displacement nontransferable?

01
Individuals who have been permanently displaced from their job due to circumstances such as being laid off, terminated, or their position being eliminated may need the supplemental job displacement nontransferable benefits.
02
These benefits are typically meant for employees who are not able to successfully regain employment in a similar position within a specific time frame after being displaced.
03
The specific eligibility criteria for the supplemental job displacement nontransferable benefits may vary depending on the laws and regulations of the jurisdiction or the policies of the employer.
04
It is advisable to consult with a relevant authority or resource, such as a state labor department or your former employer's human resources department, to determine if you qualify for these benefits and for guidance on how to fill out the necessary forms.
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Supplemental Job Displacement Nontransferable is a voucher provided to eligible employees displaced due to injury or illness who are unable to return to their previous job.
Employees who are displaced due to injury or illness and are deemed eligible for the program.
Employees can obtain the necessary forms from their employer or the appropriate state agency, and must provide information about their injury or illness and inability to return to their previous job.
The purpose is to assist displaced employees in obtaining retraining or skill enhancement to help them secure new employment.
Information about the employee's injury or illness, their inability to return to their previous job, and the training or education program they plan to pursue.
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