Workers' Comp Forms & Bulletins

Forms

Go green! Set up automatic Electronic Funds Transfers.

• EFT Authorization Form (PDF)

Supplemental applications - To download these forms, right-click and pick the "Save target as..." option. You may then email the completed form to your Workers' Compensation underwriter. We also accept completed supplemental applications from other insurance carriers.

• General Supplement (MS Word)
• Industrial Aid Aircraft (MS Word)

Bulletins

• CA Short Rate Cancellation Penalty Disclosure (PDF)
• CA Amendment to Annual Payroll for Officers (PDF)
• Workers' Comp Officers & Partners Annual Maximum Payrolls (PDF)