C.M.R. 90, 351, ch. 2, app 351-2-I

Current through 2024-51, December 18, 2024
Appendix 351-2-I

(Employees must provide the following information to the employer/insurer within 30 days of filing the Petition for Extension of Benefits.)

1. State what your present financial condition is (i.e. present monthly income vs. present monthly expenses).

2. State when and where you have looked for work in at least the last 3 months.

3. Provide a copy of your most recent tax return, if one was filed.

4. Please provide any other information that may be relevant to your present financial condition that you plan to rely on at hearing.

C.M.R. 90, 351, ch. 2, app 351-2-I