Claimant. a. Is Single Married. b. Is entitled to exemption(s). c. Claimant’s gross weekly earnings are $ using Iowa Code section 85.36( ). d. Has a rate of weekly compensation of $ . (If the rate for PPD differs, it is $ per week.)
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Samples: www.iowaworkcomp.gov, www.iowaworkcomp.gov, www.iowaworkcomp.gov
Claimant. a. Is 🞎 Single 🞎 Married. b. Is entitled to exemption(s). c. Claimant’s gross weekly earnings are $ using Iowa Code section 85.36( ). d. Has a rate of weekly compensation of $ . (If the rate for PPD differs, it is $ per week.)
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Samples: formfiles.justia.com