Form DWC-04 Employee's Certificate of Dependency Status - Rhode Island

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form DWC-04 for the current year.

Form DWC-04 Employee's Certificate of Dependency Status - Rhode Island

What Is Form DWC-04?

This is a legal form that was released by the Rhode Island Department of Labor and Training - a government authority operating within Rhode Island. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form DWC-04?
A: The Form DWC-04 is the Employee's Certificate of Dependency Status.

Q: Who is it for?
A: This form is for employees in Rhode Island.

Q: What is the purpose of the Form DWC-04?
A: The purpose of this form is to declare the dependency status of the employee.

Q: What information is required on the Form DWC-04?
A: The form requires personal information about the employee, such as name, address, and Social Security number, as well as information about dependents.

Q: Is the Form DWC-04 mandatory?
A: Yes, it is mandatory for employees in Rhode Island.

Q: When should the Form DWC-04 be completed?
A: The form should be completed and returned to your employer as soon as possible after any changes in dependency status occur.

Q: Are there any penalties for not submitting the Form DWC-04?
A: Failure to submit the form may result in a loss of certain benefits.

Q: Can I make changes to the Form DWC-04 after submission?
A: Yes, you can make changes to the form if your dependency status changes. You should notify your employer of any changes as soon as possible.

ADVERTISEMENT

Form Details:

  • Released on April 1, 2019;
  • The latest edition provided by the Rhode Island Department of Labor and Training;
  • 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 fillable version of Form DWC-04 by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Labor and Training.

Download Form DWC-04 Employee's Certificate of Dependency Status - Rhode Island

4.5 of 5 (27 votes)
  • Form DWC-04 Employee's Certificate of Dependency Status - Rhode Island

    1

  • Form DWC-04 Employee's Certificate of Dependency Status - Rhode Island, Page 2

    2

  • Form DWC-04 Employee's Certificate of Dependency Status - Rhode Island, Page 3

    3

  • Form DWC-04 Employees Certificate of Dependency Status - Rhode Island, Page 1
  • Form DWC-04 Employees Certificate of Dependency Status - Rhode Island, Page 2
  • Form DWC-04 Employees Certificate of Dependency Status - Rhode Island, Page 3
Prev 1 2 3 Next
ADVERTISEMENT