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Document Number: WKC-176-E
Description: This form is to be filed when there is approval of compensation resolving a dispute.
Comments: This form if fill enabled and can be complted on a comuter or printed out and comlpted by hand
Content Contact: Lynn Weinberger
Document Attachment:
WKC-176-E (Electronic Version - pdf/687 KB)
WKC-176 (Print Version - pdf/89 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.
DWD Contact Information
201 E. Washington Ave
P.O. Box 7946
Madison, WI 53707
(608) 266-3131
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