Sec. 14. (a) This section applies only to a claim made by the first public employer. (b) A claim must be on a form approved by the state board of accounts and signed and certified as correct by the first public employer's chief executive officer. (c) The claim must provide the following information: (1) The individual's full name. (2) The individual's hire date and end date of employment with the first public employer. (3) The individual's certification date. (4) A statement of the total costs incurred by the first public employer for which the first public employer claims reimbursement. (5) An itemized list of costs comprising the total costs stated in subdivision (4). (d) The claim must be accompanied by copies of the following: (1) The written notice, acknowledged and signed as provided in section 16 of this chapter. (2) Documents supporting each of the costs itemized under subsection (c)(5), including: (A) payroll or salary vouchers; (B) earnings records; (C) invoices, claims, or billing statements; (D) accounts payable vouchers; or (E) canceled warrants or checks.
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