![]() ![]() ![]() Note: Your paycheck stub or W-2 form usually contains this information.The name and mailing address of your last employer, no matter how long you worked there.A phone number where you can be reached during the day.Full mailing address, including apartment or lot number, Zip Code and PO Box if you use one.When filing a new application, you will need the following information: Industrial Safety and Health Expand Industrial Safety and Health.Public Employer Employee Relations Act (PEERA) Decisions Professional Negotiations Act (PNA) Decisions Workers Compensation Expand Workers Compensation. ![]()
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