Get Employee S Multiple Employment Wage Statement (dwc Form-003me). Employee S Multiple Employment Wage

Filling out the Employee's Multiple Employment Wage Statement (DWC Form-003ME) accurately is essential for ensuring that your wage information is properly submitted to the workers' compensation carrier and the Division of Workers' Compensation. This guide will provide clear, step-by-step instructions to help you complete the form online with ease.

Follow the steps to complete your wage statement accurately.

1. Click ‘Get Form’ button to obtain the Employee's Multiple Employment Wage Statement and open it in an editor.
2. Begin by providing your name, mailing address, and Social Security Number at the top of the form. This identifies you as the employee who is submitting the wage statement.
3. Fill in the Claim Employer's name and the date of injury in the designated fields. This information is crucial for establishing the context of the wage statement.
4. Under Non-Claim Employer Information, enter the business name and mailing address of any employers you worked for besides the Claim Employer. Include their Federal Tax I.D. Number if applicable.
5. Indicate whether you were working for the Non-Claim Employer on the date of injury by selecting 'YES' or 'NO'.
6. List the gross wages earned from the Non-Claim Employers in the sections provided. Ensure that you only include wages reportable for federal income tax purposes, for the 13 weeks immediately prior to the date of injury.
7. In the table format provided, fill out the Period Number, From Date, To Date, Hours Worked, and Gross Wages Earned for each pay period. Accurate reporting here is critical.
8. At the end of the form, you or a representative must certify that the wage statement is complete and accurate by signing and dating where indicated.
9. Finally, review the filled-out form for any errors, save your changes, then download, print, or share the form as required.

Ensure all your employment wage information is accurately captured and submit your documents online today.