Annual Report of Permanent Total Disability Payments Made Forms
| Form Name | Annual Report of Permanent Total Disability Payments Made |
| Form # | WKC-17876-E |
| Form Revision | (R. 10/2023) |
| Category | Forms » Disability |
| Downloads | |
| Form State | Wisconsin |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |