Social Security Information Request Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Social Security Information Request Form. This is a Wisconsin form and can be use in Workers Comp.
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Tags: Social Security Information Request, WKC-6156, Wisconsin Workers Comp,
I understand that the information requested is for computing the amount of worker222s compensation payments for which I Worker222s Compensation Division American LegalNet, Inc. www.FormsWorkFlow.com Enter employee222s nameEnter employee222s social security numberEnter employee222s addressif it is different from the number in 2233.224Return this form to the address in 2237.224 within 30 days. If you do not sign this form, your Attain Social Security Administration representative222s signatureEnter date of Social Security Administration representative222s signatureSend this completed form to the address in 2237.224Social Security Reverse Offset WorksheetWorker222s Compensation Division American LegalNet, Inc. www.FormsWorkFlow.com