Get Wi Wkc-136 2021-2025

Filling out the WI WKC-136 form is an essential step in requesting an advancement of your permanent disability benefits. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the WI WKC-136 form.

1. Click ‘Get Form’ button to access the WI WKC-136 form and open it in your preferred online editor.
2. Begin by entering your WC Claim Number in the designated field at the top of the form.
3. Fill in your name as the employee, ensuring it matches official documents for accurate processing.
4. Optionally provide your Social Security Number (SSN); be aware that omitting it may lead to processing delays.
5. Enter the date of your injury in the specified format.
6. If someone else is submitting this request on your behalf, include their name in the 'Requester Name' field.
7. Indicate if you are requesting as a beneficiary due to a work-related fatality by selecting 'Yes' or 'No'.
8. Complete your address, including number, street, city, state, and zip code.
9. State whether you are currently employed by selecting 'Yes' or 'No'.
10. If employed, enter your employer's name, phone number, and address in the provided fields.
11. Indicate your gross salary or wages along with the frequency of payment.
12. Fill in the present income from all sources as well as any social security benefits you receive.
13. List the number of dependents under 18 years of age in the designated section.
14. Detail any property owned, and include values for savings and debts under property.
15. Specify your child support obligation if applicable.
16. To assist with your request, describe the amount of money requested and the specific reason for the advancement.
17. Sign the form in the 'Certified as correct by' section, confirming the accuracy of the information provided.
18. Enter the date you signed the form and provide a telephone number for contact.
19. Once you have completed all sections, save your changes, and choose to download, print, or share the completed form.

Start filling out your WI WKC-136 form online for timely processing of your advancement request.