Ga Form Wc 6 PDF Details

Ga form Wc 6 is a legal document used in the state of Georgia. It is used to claim tax exemptions for business owners. The document must be filed annually with the Georgia department of revenue. Businesses that qualify for this exemption include sole proprietorships, general partnerships, limited liability companies, and corporations. The form can be downloaded from the Department of Revenue's website. Detailed instructions on how to complete the form are also available on the website. Filing deadline is April 15th each year. Qualifying businesses should take advantage of this tax exemption to reduce their taxable income. The amount of savings will vary depending on the business entity and its taxable income level.

Here are several details you may want to examine before dealing with the ga form wc 6.

QuestionAnswer
Form NameGa Form Wc 6
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameswage statement workers, how to wc 6, ga form wc, wc6

Form Preview Example

WC-6 WAGE STATEMENT

GEORGIA STATE BOARD OF WORKERS' COMPENSATION

WAGE STATEMENT

Board Claim No.

Employee Last Name

Employee First Name

M.I.

SSN or Board Tracking #

Date of Injury

A. IDENTIFYING INFORMATION

 

 

County of Injury

 

 

Address

 

 

EMPLOYEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail Address

 

 

 

 

City

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

Address

 

 

EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail Address

 

 

 

 

City

State

Zip Code

 

 

 

 

 

 

 

 

 

 

INSURER/

 

Name

 

 

 

SBWC ID# (five digit number)

 

 

 

 

 

 

 

 

 

 

SELF-INSURER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

Claims Office Address

 

 

 

 

CLAIMS OFFICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail Address

 

 

Insurer/Self-Insurer File #

 

City

State

Zip Code

 

 

 

 

 

 

 

 

 

 

B. COMPUTATION OF AVERAGE WEEKLY WAGE

If the weekly benefit is less than the maximum, complete the schedule below for thirteen (13) weeks immediately preceding the accident. If the employee has not been in your employ for the thirteen (13) weeks, complete this schedule showing gross weekly earnings of a similar employee in the same employment.

13 Weeks of Employee’s Wages

13 Weeks of a Similar Employee’s

Full time weekly wage of injured employees

Wages

 

 

Wage at date of injury per week:

SCHEDULE OF WEEKLY EARNINGS

 

From

To

No. of

Gross

 

Value of Additional Compensation

 

 

 

Amount Paid

 

 

 

 

 

Total

Week

Date

Date

Days

Including

 

 

 

 

 

 

 

 

 

 

Earnings

 

MM/DD/YYYY

MM/DD/YYYY

Worked

Overtime or

Meals

Lodging

Rent

Tips

Other

 

 

 

 

 

 

Extra Work

 

 

 

 

 

 

1

2

3

4

5

6

7

8

9

10

11

12

13

Total

Average Weekly Earnings

C.

REMARKS:

REQUIRED TO COMPLETE:

OFF

Mon

Tue

Wed

Thur

DAYS

Fri

Sat

Sun

 

 

 

Type or Print Name

E-mail Address

Signature

Date

 

 

Phone Number

IF YOU HAVE QUESTIONS PLEASE CONTACT THE STATE BOARD OF WORKERS’ COMPENSATION AT 404-656-3818 OR 1-800-533-0682 OR VISIT http://www.sbwc.georgia.gov

WILLFULLY MAKING A FALSE STATEMENT FOR THE PURPOSE OF OBTAINING OR DENYING BENEFITS IS A CRIME SUBJECT TO PENALTIES OF UP TO $10,000.00 PER VIOLATION (O.C.G.A. §34-9-18 AND §34-9-19).

WC-6

REVISION . 07/2011

6

WAGE STATEMENT

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