Get Form Wc-119. Affidavit In Support Of Redemption Agreement - Michigan

Filling out the Form WC-119 is a crucial step in the process of settling a workers’ compensation claim in Michigan. This guide provides clear, step-by-step instructions to help you complete the affidavit accurately and ensure that your rights are protected.

Follow the steps to effectively complete the Form WC-119 online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. In the first section, fill in your name as the plaintiff and the name of the defendant(s). Make sure to double-check for accuracy.
3. In the statement regarding your employment, enter the name of your employer and the date of the injury. Be precise with these details as they are vital for the record.
4. Confirm that you voluntarily agree to the redemption agreement. This is a key affirmation and should be taken seriously.
5. Discuss your understanding with your attorney or magistrate regarding the rights you hold under the Workers’ Disability Compensation Act and how the agreement may affect those rights.
6. Provide information about your injuries or disabilities. This section should reflect a complete understanding of your health situation.
7. Indicate if you have health or disability insurance, along with any relevant details about the coverage.
8. Summarize your average monthly expenses to provide a comprehensive view of your financial situation.
9. After filling in all sections, review your entries for accuracy. Once satisfied, sign the affidavit and ensure it is notarized.
10. You may then save changes, download the completed form, print it, or share it as necessary.

Complete your documents online to streamline your settlement process.