Get Ak 07-6101 2018-2025

The AK 07-6101 form is essential for reporting occupational injuries or illnesses to the Alaska Division of Workers' Compensation. This guide provides clear instructions on how to complete the form online effectively and accurately.

Follow the steps to fill out the AK 07-6101 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the employer information section. Complete all fields marked with an asterisk (*), including the employer's name, FEIN, and mailing address.
3. Next, provide the industry code as required for new claims. You can find this code on the provided census website link.
4. Input the contact name and telephone number for the employer, ensuring accuracy to facilitate communication.
5. Proceed to the employee's information section. Enter the employee's full name, date of birth, mailing address, and, if applicable, date of death.
6. Complete the employee ID type and number, ensuring to select the appropriate option from the dropdown.
7. Fill out blocks 13-20, which are specific to the insurer or claims administrator, providing necessary claim details.
8. Continue with policy information and the claim administrator's details, including their name, address, and FEIN.
9. Provide information regarding the insured, including name and FEIN, then complete the employment status and days worked per week.
10. Specify the nature and cause of the injury or illness, detailing applicable body parts affected and any accident site information.
11. Fill out the employer's knowledge of the injury and the first day worked following the incident, paying attention to any associated codes.
12. Finally, review all entered information for accuracy. You can then save changes, download, print, or share the form as needed.

Complete your AK 07-6101 form online today for a smoother filing process.