Florida
Workers Comp
Last updated: 9/1/2023
Verified Motion For Assignment Of Substitute Identification Number
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Description
VERIFIED MOTION FOR ASSIGNMENT OF SUBSTITUTE IDENTIFICATION NUMBER. This form is used in the State of Florida for cases related to workers' compensation claims when an employee or claimant does not have or declines to provide their Social Security Number (SSN). The form requires the claimant's name, date of birth, current or last known address, and a statement indicating the lack of an SSN. Fill this form in completely, sign it in the presence of a commissioned notary, show identification to the notary, and submit this completed form along with your Petition for Benefits or Request for Assignment of Case Number. www.FormsWorkflow.com
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