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Get and Sign BWageb Statement BFormb 2013-2022

Get and Sign BWageb Statement BFormb 2013-2022

Use a BWageb Statement BFormb 2013 template to make your document workflow more streamlined.

Prepared Injured Employee s Name Date of Injury IWIF Claim Number Please list the employee s weekly gross earnings for each of the 14 weeks immediately prior to the date / week of the accident. Please call your IWIF claims representative if you have any questions. 1-800-264-4943. Thank you. Wage Statement Rev* for IWIF 09/13....
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