ET-1908
Form Local Employer / State Employer

Employer Attestation For Documentation Received

Employers, use this form to verify that you viewed the employee’s original required document(s) to verify the employee or dependent(s) is eligible for benefit coverage, as administered by ETF.

Income Continuation Insurance for Employers

ICI is a voluntary “income replacement” benefit payable to an enrolled employee if they become disabled. This program is only
offered to employers already participating in the WRS.