Get Wkc 136 Advancement Or Lump Sum Request Form

Filling out the Wkc 136 Advancement Or Lump Sum Request Form is an essential step in seeking financial assistance for your permanent disability benefits. This guide will provide you with clear, step-by-step instructions to help you complete the form online with ease.

Follow the steps to accurately complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your WC claim number, which is for office use only, in the designated field.
3. Input your full name as the employee in the specified section.
4. Provide your Social Security number in the relevant field.
5. Fill in your complete address, which includes number, street, city, state, and zip code.
6. Indicate the date of your injury in the specified section.
7. Add your telephone number, ensuring it is complete, including area code.
8. Answer the question regarding your current employment status by selecting 'Yes' or 'No'.
9. Provide today’s date and your date of birth in the appropriate fields.
10. Select your marital status from the options: married, single, separated, or divorced.
11. If you are currently employed, enter your employer's name and phone number.
12. Complete your employer's address by providing the relevant number, street, city, state, and zip code.
13. Fill in your gross salary or wages, along with the frequency (e.g., weekly, bi-weekly).
14. Provide current income sources including Social Security benefits if applicable.
15. Indicate the number of dependents under 18 years of age.
16. List any property owned, both personal and real estate.
17. Detail your working hours per week in the designated area.
18. If applicable, enter your spouse's gross wages and the frequency.
19. Specify any child support obligations you currently have.
20. Provide information about savings and debts owed on property.
21. Clearly state the amount you are requesting and the reason for your advancement request, along with any supporting bills.
22. Finally, sign and date the form, certifying that all information provided is correct.
23. Once completed, save your changes and download or print the form as needed before submission.

Complete your Wkc 136 Advancement Or Lump Sum Request Form online today to ensure your financial needs are addressed efficiently.