Missouri Department of Labor and Industrial Relations Forms

This Form is used for reporting quarterly wages in Missouri. It is a continuation sheet for the MODES-10B Quarterly Wage Report.

This form is used for an employee to voluntarily waive their rights to workers' compensation benefits in Missouri.

This form is used for conducting a wage survey for contractors in the state of Missouri. It helps analyze and collect information about the prevailing wages in the construction industry.

This form is used for collecting information about complaints against places of public accommodations in Missouri. It serves as an intake questionnaire to gather details regarding the nature of the complaint.

This Form is used for voluntary payment work sheet for shared work employers in Missouri.

This form is used for employers in Missouri to request a change in their employer status.

This form is used for reporting unemployment insurance fraud in the state of Missouri.

This form is used for obtaining authorization from a worker's compensation claimant in Missouri to disclose their worker's compensation records.

This Form is used for claiming compensation benefits for line of duty (WCLoD) when the worker's death occurred between August 28, 2017, and August 28, 2018 in Missouri.

This form is used for obtaining authorization from a claimant to release their records in the state of Missouri.

This document is a form used in Missouri for claiming compensation for line of duty compensation benefits when the worker's death occurred before August 28, 2017.

This form is used for submitting an intake questionnaire for housing complaints in Missouri.

This form is used for claiming compensation for line of duty compensation benefits in the state of Missouri when a worker's death occurred on or after August 28, 2018.

This document is a toolbox talk form that addresses carbon monoxide safety in the state of Missouri. It provides information and guidelines for preventing exposure to carbon monoxide and ensuring safety in the workplace.

This Form is used for conducting a toolbox talk in Missouri, specifically focused on emergency procedures and preparedness.

This form is used for conducting a toolbox talk on the topic of fatigue in Missouri. It provides information and guidance to address the issue of fatigue in the workplace.

This form is used for conducting toolbox talks related to the inspection of forklifts and powered industrial trucks in Missouri.

This Form is used for conducting a toolbox talk in Missouri about lifting and back safety. It provides guidelines and information to ensure safe lifting practices to prevent back injuries.

This form is used for conducting a Toolbox Talk on Safety Data Sheets (SDS) in Missouri. It helps promote safety awareness and provides information on how to properly handle hazardous materials.

This type of document is used for submitting an annual mining report in the state of Missouri.