Get Dol Ee-4 2016-2025

Filling out the DoL EE-4 form is an essential process for affirming the employment history of an employee. This guide provides a clear and step-by-step approach to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the DoL EE-4 form online

1. Click the ‘Get Form’ button to access the EE-4 form and open it in the editor.
2. Begin filling out the employee's information section by printing their name clearly in the designated fields. Include the last name, first name, and middle initial.
3. If applicable, provide the employee's maiden or former name in the specified field.
4. In the 'Your Information' section, enter your name clearly, including the last name, first name, and middle initial.
5. If you know the employee's Social Security number, enter it in the appropriate field.
6. Provide your telephone numbers, making sure to include your home, work, and cell phone numbers, if applicable.
7. Enter your complete address, including the street address, apartment number (if applicable), city, state, and ZIP code.
8. Indicate your relationship to the employee by checking the applicable boxes from the provided options.
9. For the employee's work history, provide detailed information about the employee’s work location, including facility name, location, building details, contractor names, and the employee's occupation and title.
10. List the dates during which you know the employee worked at the facility, ensuring to provide clear start and end dates.
11. If you worked with the employee during this time, include your own occupation, title, and the dates you were at the facility.
12. In the 'Work History Narrative' section, describe in detail the types of work the employee performed at the facility. Include relevant work processes and any information that confirms their employment.
13. Once you have completed all sections, review your entries for accuracy.
14. Finally, ensure to sign and date the form at the bottom of the second page, affirming that the information you provided is true.
15. After completing the form, you can choose to save changes, download, print, or share the EE-4 form as needed.

Complete your DoL EE-4 form online today to facilitate the claims process!