Form AWW-1 Average Weekly Wage Certification Adopted January 1 1997 KENTUCKY DEPARTMENT OF WORKERS CLAIMS CLAIM NUMBER PLAINTIFF VS WAGE CERTIFICATION DEFENDANTS Date of Injury/Exposure as reported on Form 101/102/103 Method of Wage Payment check one Hourly Weekly Salary Yearly Salary Monthly Salary Output of Employee Date of Hire or Employment Daily Status or Classification of Employment check one Seasonal Full-time Volunteer Probationary Apprentice/Trainee Did Employer provide any of the...
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