Self Insurance Templates

This Form is used for filing the Self-insurer's Tax Return in Utah. It provides instructions to self-insurers on how to properly complete and file their tax return.

This form is used for obtaining a self-insurers' representative's bond in the state of New York.

This form is used for self-insurers in Utah to make tax payments.

This Form is used for self-insured companies in Arizona to notify termination of their self-insurance status.

This form is used for businesses in Arizona to apply for authority to self-insure their accounting matters.

This Form is used for companies in Arizona to apply for authority to self-insure their workers' compensation liabilities under Arizona Revised Statutes 23-961.01.

This form is used for applying for a permanent certificate of consent to self-insure for interim self-insurer in the state of California. It allows companies to self-insure their workers' compensation claims.

This form is used for authorizing a corporation to apply for a certificate of consent to self-insure workers' compensation liabilities in the State of California.

This Form is used for authorizing a corporate resolution to apply for a Certificate of Consent to self-insure workers' compensation liabilities in the State of California.

This form is used for applying for an Affiliate Certificate of Consent to Self-insure as a Member of a Group Self-insurer in California.

This document is used for applying for a Certificate of Consent to self-insure as a private employer self-insurer in the state of California.

This Form is used for public agencies in California to apply for a Certificate of Consent to self-insure as an employer.

This form is used for applying for a certificate of consent to self-insure as a group self-insurer in California. It is intended for groups who want to self-insure for workers' compensation coverage.

This form is used for obtaining a certificate of self-insurance in California, allowing individuals or businesses to self-insure their financial responsibility for certain liabilities.

This form is used for Alabama employers who wish to apply for self insurance for workers' compensation coverage.

This form is used for self-insurers in Kentucky to enter into a guarantee agreement.

This form is used for applying for self-insurance authorization in the state of Hawaii.

This form is used for applying for self-insurance authorization in the state of Hawaii.

This document is used for requesting a Statement of Self-insurance in Hawaii. It provides instructions on how to complete and submit Form RM-SOSI.

This form is used for conducting the Financial Self-insurance Test in the state of Kentucky. It is designed to evaluate the financial stability and capability of an entity to self-insure certain risks.

This document provides a checklist for individuals in Michigan who are applying for self-insurance. It outlines the necessary steps and requirements to complete the application process.

This document is for groups in Missouri who are authorized to self-insure for workers' compensation. It covers the tax requirements for these self-insured groups as mandated by the state law.

This document provides instructions for Missouri groups authorized to self-insure worker's compensation tax. It outlines the requirements and procedures for filing and paying the tax as per the Missouri Revised Statutes.

This form is used for self-insured companies in Minnesota to report their outstanding losses. It helps the state track and monitor the financial standing of these companies.

This form is used for self-insurance companies in Missouri to establish their by-laws.

This form is used for companies or organizations in Missouri to apply for authority to self-insure workers' compensation coverage.

This form is used for applying for group self-insurance in the state of Missouri. It allows businesses and organizations to apply to become self-insured for workers' compensation coverage.

This Form is used for applying for self-insurance in the state of Nevada.

This form is used for recording self-insurance loss experience in the state of Nevada. It is used by individuals or companies who have chosen to self-insure their liability or workers' compensation coverage. The form helps track and document any losses experienced under the self-insurance program.

This form is used for self-insurers in Nevada who want to use an adjusting company to settle claims. The form is an affidavit and provides the necessary information for self-insurers to confirm their use of an adjusting company.

This form is used for completing a self insurance questionnaire specific to the state of New Hampshire. It is required for individuals or entities seeking to self-insure in the state.

This form is used for obtaining a self-insurance surety bond in the state of New Hampshire. It is required for businesses or organizations that wish to self-insure their liabilities instead of purchasing insurance from a traditional insurer. The bond provides financial protection in the event that the self-insuring entity fails to meet its obligations.

This form is used for obtaining a surety bond for self-insurers of workers' compensation in the state of Oklahoma.

This Form is used for acknowledging the Self-insured Joint Settlement Agreement and Release in Ohio.

This form is used for political subdivisions or fire districts in New York to notify their election to secure compensation as a self-insure.

This Form is used for updating the records of self-insurers in the state of New York.