Form Wyo 065 - Payment Coupon
ADVERTISEMENT
1Payment Coupon
WYO 065
01 / 06 / 09
DO NOT USE THIS FORM AS A SUBSTITUTE
FOR THE SUMMARY REPORT
●
Business Name
Check #
Quarter/Year
WC Employer #
WC Amount
Paid $
Check Amount $
State Use Only
Date Received
Payment Type
Initials
Postmark
Date
●
Return to:
Wyoming Department of Employment
Workers' Safety & Compensation
Employer Services
P O Box 20006
Cheyenne WY 82003
from internet
FISCAL
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal