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  • Dol Ca-2231 2016

Get Dol Ca-2231 2016-2026

Employers ' Claim For Reimbursement Assisted Reemployment (AR) ProgramU.S. Department of LaborPrintOffice of Workers ' Compensation ProgramsResetInstructions: Complete items 1 through 15 and send.

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How to use or fill out the DoL CA-2231 online

The DoL CA-2231 form is essential for employers seeking reimbursement under the Assisted Reemployment Program. This guide will provide you with clear, step-by-step instructions on how to complete the form online, ensuring a smooth submission process.

Follow the steps to effectively fill out the DoL CA-2231 online.

  1. Click ‘Get Form’ button to obtain the form and open it for editing.
  2. Enter the employer's name in the designated field, which is the first item on the form.
  3. Provide the employer's phone number in the following field.
  4. Fill in the employer's street or post office box number, along with the city, state, and zip code.
  5. Complete the employer's tax I.D. number in the specified section.
  6. Input the employer's assigned bill payment/provider number.
  7. Enter the employee's name in the relevant field, specifying last name, first name, and middle initial.
  8. Provide the employee's OWCP file number.
  9. If the employee has signed the form, proceed; otherwise, include an explanation in the comments section.
  10. Indicate the work date range claimed, filling in the 'From' and 'To' dates as well as the total work hours for reimbursement.
  11. Specify the pay rate per hour in the designated field.
  12. Fill in the total hours worked and total gross amount earned by the employee.
  13. State the amount of reimbursement claimed in the respective field.
  14. The supervisor should certify the accuracy of the provided information by signing and dating the form.
  15. Once all fields are completed, save changes, and download, print, or share the form as needed.

Complete your documentation online to ensure timely processing of your claims.

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