Form 07-6169 Employer's Notice of 90 Consecutive Days of Time Loss for Injuries - Alaska

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.

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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.

Download Form 07-6169 Employer's Notice of 90 Consecutive Days of Time Loss for Injuries - Alaska

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  • Form 07-6169 Employers Notice of 90 Consecutive Days of Time Loss for Injuries - Alaska, Page 1
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