STATEMENT OF SELF-RESTRICTION TO PART-TIME WORK Forms
| Form Name | STATEMENT OF SELF-RESTRICTION TO PART-TIME WORK |
| Form # | WKC-12698-E |
| Form Revision | (R. 09/2024) |
| Category | Forms » Return To Work/Voc Rehab |
| Downloads | |
| Form State | Wisconsin |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |