Establishing secure connection… Loading editor… Preparing document…
Navigation

Fill and Sign the Report of Payment Supplemental Form

Fill and Sign the Report of Payment Supplemental Form

How it works

Open the document and fill out all its fields.
Apply your legally-binding eSignature.
Save and invite other recipients to sign it.

Rate template

4.7
57 votes
฀฀฀ ฀฀ ฀฀฀฀ ฀฀ ฀฀ ฀฀ DWC No: Name Insurance/Adjusting Co. Max. No. of Exemptions ____ Single             Base Compensation Rate             Total Number of Weeks and Days       Total Spendable Earnings             - - / / Report of Payment Supplemental For a Variable Partial THIS FORM MUST BE ATTACHED TO A DWC-22 (REPORT of PAYMENT) EMPLOYEE INFORMATION: Soc. Sec. No CLAIM INFORMATION: Employer Married Injury date Incapacity date RATE INFORMATION: AWW, including overtime COLA Rate Spendable Base Wage AWW, excluding overtime Weekly Compensation: Week Gross Spendable Amount Week Gross Spendable Amount Ending Earnings Earnings Paid Ending Earnings Earnings Paid 11 15 2 - 30 16 17 4 18 5 19 6 20 7 21 8 22 9 23 10 24 11 25 12 26 13 27 14 28 Total Compensation Paid Insurer's Signature Date THIS FORM MUST BE ATTACHED TO A DWC-22 (REPORT of PAYMENT) DWC-22a (8/98)

Useful advice for finalizing your ‘Report Of Payment Supplemental’ online

Fed up with the complexities of handling documents? Discover airSlate SignNow, the premier eSignature solution for individuals and businesses. Bid farewell to the tedious routine of printing and scanning files. With airSlate SignNow, you can seamlessly complete and sign documents online. Take advantage of the powerful features embedded in this user-friendly and cost-effective solution and transform your document management practices. Whether you require form approvals or the collection of electronic signatures, airSlate SignNow manages it all effortlessly, with just a few clicks.

Follow this detailed guide:

  1. Access your account or initiate a trial version of our service.
  2. Click +Create to upload a file from your device, cloud storage, or our collection of templates.
  3. Open your ‘Report Of Payment Supplemental’ in the editor.
  4. Click Me (Fill Out Now) to finalize the document on your end.
  5. Add and designate fillable fields for others (if necessary).
  6. Proceed with the Send Invite settings to solicit eSignatures from others.
  7. Download, print your copy, or convert it into a reusable template.

No need to worry if you wish to collaborate with your colleagues on your Report Of Payment Supplemental or send it for notarization—our platform provides all the tools you need to accomplish these tasks. Sign up with airSlate SignNow today and take your document management to new levels!

Here is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Need help? Contact Support

The best way to complete and sign your report of payment supplemental form

Save time on document management with airSlate SignNow and get your report of payment supplemental form eSigned quickly from anywhere with our fully compliant eSignature tool.

How to Sign a PDF Online How to Sign a PDF Online

How to complete and sign paperwork online

Previously, working with paperwork required pretty much time and effort. But with airSlate SignNow, document management is quick and simple. Our robust and easy-to-use eSignature solution enables you to effortlessly fill out and eSign your report of payment supplemental form online from any internet-connected device.

Follow the step-by-step guidelines to eSign your report of payment supplemental form template online:

  • 1.Register for a free trial with airSlate SignNow or log in to your account with password credentials or SSO authentication.
  • 2.Click Upload or Create and import a form for eSigning from your device, the cloud, or our form library.
  • 3.Click on the document name to open it in the editor and use the left-side menu to fill out all the blank fields appropriately.
  • 4.Drop the My Signature field where you need to approve your sample. Type your name, draw, or upload a photo of your regular signature.
  • 5.Click Save and Close to finish editing your completed document.

Once your report of payment supplemental form template is ready, download it to your device, export it to the cloud, or invite other individuals to eSign it. With airSlate SignNow, the eSigning process only requires a couple of clicks. Use our powerful eSignature tool wherever you are to manage your paperwork efficiently!

How to Sign a PDF Using Google Chrome How to Sign a PDF Using Google Chrome

How to complete and sign paperwork in Google Chrome

Completing and signing paperwork is simple with the airSlate SignNow extension for Google Chrome. Installing it to your browser is a fast and effective way to deal with your forms online. Sign your report of payment supplemental form sample with a legally-binding eSignature in a few clicks without switching between tools and tabs.

Follow the step-by-step guide to eSign your report of payment supplemental form template in Google Chrome:

  • 1.Go to the Chrome Web Store, locate the airSlate SignNow extension for Chrome, and add it to your browser.
  • 2.Right-click on the link to a form you need to approve and choose Open in airSlate SignNow.
  • 3.Log in to your account with your password or Google/Facebook sign-in buttons. If you don’t have one, sign up for a free trial.
  • 4.Utilize the Edit & Sign toolbar on the left to complete your template, then drag and drop the My Signature option.
  • 5.Upload a photo of your handwritten signature, draw it, or simply enter your full name to eSign.
  • 6.Make sure all the details are correct and click Save and Close to finish modifying your form.

Now, you can save your report of payment supplemental form sample to your device or cloud storage, send the copy to other people, or invite them to eSign your form with an email request or a protected Signing Link. The airSlate SignNow extension for Google Chrome enhances your document processes with minimum time and effort. Start using airSlate SignNow today!

How to Sign a PDF in Gmail How to Sign a PDF in Gmail How to Sign a PDF in Gmail

How to fill out and sign forms in Gmail

Every time you get an email containing the report of payment supplemental form for signing, there’s no need to print and scan a document or download and re-upload it to another program. There’s a better solution if you use Gmail. Try the airSlate SignNow add-on to promptly eSign any documents right from your inbox.

Follow the step-by-step guide to eSign your report of payment supplemental form in Gmail:

  • 1.Navigate to the Google Workplace Marketplace and find a airSlate SignNow add-on for Gmail.
  • 2.Install the program with a corresponding button and grant the tool access to your Google account.
  • 3.Open an email containing an attachment that needs approval and utilize the S sign on the right sidebar to launch the add-on.
  • 4.Log in to your airSlate SignNow account. Choose Send to Sign to forward the document to other parties for approval or click Upload to open it in the editor.
  • 5.Put the My Signature field where you need to eSign: type, draw, or upload your signature.

This eSigning process saves time and only requires a couple of clicks. Utilize the airSlate SignNow add-on for Gmail to update your report of payment supplemental form with fillable fields, sign forms legally, and invite other individuals to eSign them al without leaving your mailbox. Enhance your signature workflows now!

How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device

How to fill out and sign paperwork in a mobile browser

Need to quickly submit and sign your report of payment supplemental form on a mobile phone while working on the go? airSlate SignNow can help without needing to install extra software programs. Open our airSlate SignNow solution from any browser on your mobile device and add legally-binding eSignatures on the go, 24/7.

Follow the step-by-step guide to eSign your report of payment supplemental form in a browser:

  • 1.Open any browser on your device and go to the www.signnow.com
  • 2.Sign up for an account with a free trial or log in with your password credentials or SSO option.
  • 3.Click Upload or Create and pick a file that needs to be completed from a cloud, your device, or our form collection with ready-to go templates.
  • 4.Open the form and fill out the empty fields with tools from Edit & Sign menu on the left.
  • 5.Place the My Signature area to the form, then enter your name, draw, or add your signature.

In a few simple clicks, your report of payment supplemental form is completed from wherever you are. Once you're done with editing, you can save the file on your device, create a reusable template for it, email it to other people, or ask them to electronically sign it. Make your documents on the go quick and efficient with airSlate SignNow!

How to Sign a PDF on iPhone How to Sign a PDF on iPhone

How to fill out and sign documents on iOS

In today’s business community, tasks must be completed quickly even when you’re away from your computer. With the airSlate SignNow application, you can organize your paperwork and sign your report of payment supplemental form with a legally-binding eSignature right on your iPhone or iPad. Install it on your device to conclude agreements and manage forms from anyplace 24/7.

Follow the step-by-step guidelines to eSign your report of payment supplemental form on iOS devices:

  • 1.Go to the App Store, search for the airSlate SignNow app by airSlate, and install it on your device.
  • 2.Open the application, tap Create to import a template, and select Myself.
  • 3.Choose Signature at the bottom toolbar and simply draw your autograph with a finger or stylus to eSign the sample.
  • 4.Tap Done -> Save right after signing the sample.
  • 5.Tap Save or use the Make Template option to re-use this paperwork later on.

This process is so easy your report of payment supplemental form is completed and signed in a couple of taps. The airSlate SignNow application works in the cloud so all the forms on your mobile device are kept in your account and are available whenever you need them. Use airSlate SignNow for iOS to improve your document management and eSignature workflows!

How to Sign a PDF on Android How to Sign a PDF on Android

How to complete and sign paperwork on Android

With airSlate SignNow, it’s simple to sign your report of payment supplemental form on the go. Set up its mobile app for Android OS on your device and start enhancing eSignature workflows right on your smartphone or tablet.

Follow the step-by-step guidelines to eSign your report of payment supplemental form on Android:

  • 1.Go to Google Play, find the airSlate SignNow app from airSlate, and install it on your device.
  • 2.Log in to your account or register it with a free trial, then upload a file with a ➕ button on the bottom of you screen.
  • 3.Tap on the imported document and choose Open in Editor from the dropdown menu.
  • 4.Tap on Tools tab -> Signature, then draw or type your name to electronically sign the sample. Complete empty fields with other tools on the bottom if necessary.
  • 5.Utilize the ✔ button, then tap on the Save option to end up with editing.

With a user-friendly interface and total compliance with primary eSignature requirements, the airSlate SignNow application is the perfect tool for signing your report of payment supplemental form. It even works without internet and updates all record adjustments when your internet connection is restored and the tool is synced. Fill out and eSign forms, send them for eSigning, and make re-usable templates anytime and from anywhere with airSlate SignNow.

Sign up and try Report of payment supplemental form
  • Close deals faster
  • Improve productivity
  • Delight customers
  • Increase revenue
  • Save time & money
  • Reduce payment cycles