PDF
Word
Form 07-6169 Employer's Notice of 90 Consecutive Days of Time Loss for Injuries - Alaska
What Is Form 07-6169?
This is a legal form that was released by the Alaska Department of Labor and Workforce Development - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 07-6169?
A: Form 07-6169 is the Employer's Notice of 90 Consecutive Days of Time Loss for Injuries in Alaska.
Q: What is the purpose of Form 07-6169?
A: The purpose of Form 07-6169 is to notify the Alaska Workers' Compensation Board when an employee has been on time loss for 90 consecutive days.
Q: When should Form 07-6169 be filed?
A: Form 07-6169 should be filed when an employee has been out of work due to a work-related injury for 90 consecutive days.
Q: Who should file Form 07-6169?
A: The employer should file Form 07-6169 to notify the Alaska Workers' Compensation Board.
Q: What information is required on Form 07-6169?
A: Form 07-6169 requires information about the injured employee, the employer, the injury details, and the dates of time loss.
Form Details:
- Released on February 1, 2015;
- The latest edition provided by the Alaska Department of Labor and Workforce Development;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form 07-6169 by clicking the link below or browse more documents and templates provided by the Alaska Department of Labor and Workforce Development.
