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Form DWC5307.12 Disclosure of Contract Reimbursement Rate - California
What Is Form DWC5307.12?
This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DWC5307.12?
A: Form DWC5307.12 is the Disclosure of Contract Reimbursement Rate form in California.
Q: Who is required to fill out Form DWC5307.12?
A: Contractors who provide services to injured workers are required to fill out this form.
Q: What is the purpose of Form DWC5307.12?
A: The purpose of this form is to disclose the contract reimbursement rate for services provided to injured workers.
Q: Is Form DWC5307.12 specific to California?
A: Yes, this form is specific to California and is used by contractors in the state.
Q: Are there any deadlines for submitting Form DWC5307.12?
A: Yes, contractors are required to submit this form annually by a certain deadline.
Q: Is Form DWC5307.12 mandatory?
A: Yes, contractors providing services to injured workers in California are required to fill out this form.
Q: What information is required on Form DWC5307.12?
A: The form requires contractors to provide information about their contract reimbursement rate.
Form Details:
- Released on July 1, 2021;
- The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
- 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 DWC5307.12 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.
