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Get Nc Ic Form 25t 2013
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How to fill out the NC IC Form 25T online
Filing the NC IC Form 25T online is essential for employees requesting reimbursement for travel expenses related to medical treatment under the Workers' Compensation Act. This guide provides detailed instructions on how to navigate the form easily and accurately.
Follow the steps to successfully complete the form.
- Press the ‘Get Form’ button to access the form and open it in the editor.
- Begin by entering the employee's and employer's information in the corresponding fields. This includes the employee’s name, employer's name, FEIN, and contact information.
- Input the insurance carrier details, including the carrier code and file number. Ensure to verify the contact number and address for accuracy.
- In the expenses section, fill in the date of travel, total miles traveled round trip, the name of the medical provider, and any other expenses incurred during the trip.
- Calculate the total reimbursement by multiplying the total miles by the applicable mileage rate, which is currently $0.56 per mile. Additionally, include any approved overnight stay or meal expenses, as well as other related expenses.
- certify the accuracy of the expenses by signing in the designated area. Once all sections are complete, review the information for correctness.
- After completing the form, you can save your changes, download the document for your records, print it, or share it as needed.
Complete the NC IC Form 25T online to ensure timely processing of your travel expense reimbursement.
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In North Carolina, almost all employers are required to carry workers' compensation insurance. This coverage is essential for protecting employees from financial loss due to work-related injuries. If you are unsure about your rights and obligations, the NC IC Form 25T can guide you through the necessary steps.
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