- Form A-1 Application For A Private Entity Certificate Of Consent To Self Insure {A-1}
- Form A-2 Application For-A Public Entity Certificate To Self-Insurer {A-2}
- Form A-3A Private Affiliate Interim Application {A-3A}
- Form A-3B Application For A Permanent Certificate Of Consent To Self Insure {A-3B}
- Form A-4 Agreement Of Assumption And Guarantee Of Workers Compensation Liabilities {A-4}
- Form A4-50 Application For A Certificate To Administer WC Claims {A4-50}
- Form A-5 Corporate Resolution Authorizing Application {A-5}
- Form A-6 Agreement And Undertaking For Security Deposit {A-6}
- Form S-1 Group Master Application For Certificate Of Consent To Self Insure {S-1}
- Form S-2A Group Affiliate Member Interim Application {S-2A}
- Form S-2B Application For Affiliate Certificate Of Consent To Self-Insure {S-2B}
- Form S-3 Corporate Resolution {S-3}
- Form S-4 Indemnity Agreement And Power Of Attorney {S-4}
- Form S-5 Agreement Of Assumption And Guarantee Of Workers Compensation {S-5}
- Form S-6 Agreement And Undertaking For Security Deposit {S-6}
- Report Of Transfer Of Records
- Resolution Of Agreement Of Parental Assumption And Guarantee