In order to ensure that your workers' compensation claim is processed correctly, it is important to understand and complete the WB42 form. This document is used by insurance providers to determine benefits that may be due to an injured worker. The form can be complex, so it's important to know what information is required in order to receive the appropriate benefits. By understanding the WB42 form, you can ensure that your workers' compensation claim is handled efficiently and accurately.
The following are some specifics of wb42. Our suggestion is that you read this info before you start editing the form.
| Question | Answer |
|---|---|
| Form Name | Wb42 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | what is wb42 form, wb 42 amendment to listing contract, wisconsin amendment to land contract form, amendment listing contract |
Approved by the Wisconsin Real Estate Examining Board
1It is agreed that the Listing Contract dated ________________________, ________, between the undersigned, for
2sale of the property known as (Street Address/Description) ___________________________________________
3in the ___________________________________ of _______________________________________, County of
4_____________________________________________________________ , Wisconsin is amended as follows:
5 The list price is changed from $_____________________________ to $ ____________________________.
6 The expiration date of the contract is changed from midnight ___________________________, ________ to
7midnight ___________________________________________________________________, __________.
8 The following items are (added to)(deleted from) STRIKE ONE the list of property to be included in the list
9price: _______________________________________________________________________________.
10_______________________________________________________________________________________
11 Other: _______________________________________________________________________________
12________________________________________________________________________________________
13________________________________________________________________________________________
14________________________________________________________________________________________
15________________________________________________________________________________________
16________________________________________________________________________________________
17________________________________________________________________________________________
18________________________________________________________________________________________
19________________________________________________________________________________________
20________________________________________________________________________________________
21________________________________________________________________________________________
22_______________________________________________________________________________________
23ALL OTHER TERMS OF THIS CONTRACT AND ANY PRIOR AMENDMENTS REMAIN UNCHANGED.
24CAUTION: Agents (salespersons) for Broker (firm) do not have the authority to enter into a mutual
25agreement to terminate a listing contract, amend the commission amount or shorten the term of a
26listing contract, without the written consent of the Agent(s)’ supervising broker.
27 |
__________________________________________ |
(x) ______________________________________ |
||
28 |
Broker/Firm |
Date |
Seller’s Signature |
Date |
29 |
|
|
Print name |
|
30 |
(x) __________________________________________ |
(x) ______________________________________ |
||
31 |
By |
Date |
Seller’s Signature |
Date |
32 |
Print name |
|
Print name |
|