Steps To Filing A Workers' Compensation Claim
Workers Compensation Form 61A. Click here to complete the form and receive your acknowledgement of compliance. Click the “next” button to continue to the “owner/contractor’s information” section.
Certificate of workers' compensation insurance (form 61a) | virginia workers' compensation commission Enter the business owner / contractor’s name, mailing address and phone number, all information is required. Change in condition claims response form. Click here to file the certificate of workers' compensation insurance (form 61a) online. Search expenditures assessment eva transparency reports Web electronic filing of the contractor certification form 61a is now available. All information requested is required. Web virginia workers' compensation commission. Web go to the 61a form website at: Enter the complete name of business.
Return this form to the licensing authority. Form 61 a is available online at. Change in condition claims response form. Franklin street richmond, va 23219 name of business owner /contractor last:. Enter the complete name of business. All information requested is required. Web contractors that do not list insurance coverage are asked to provide a reason. Web virginia workers' compensation commission. Virginia workers’ compensation commission attention: Return this form to the licensing authority. Search expenditures assessment eva transparency reports
