This is a legal form that was released by the California Department of Industrial Relations - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form A-5?
A: Form A-5 is a corporate resolution authorizing application to the Director of Industrial Relations, State of California for a Certificate of Consent to Self-insure Workers' Compensation Liabilities.
Q: What is the purpose of Form A-5?
A: The purpose of Form A-5 is to obtain the necessary authorization to self-insure workers' compensation liabilities in the state of California.
Q: Who needs to fill out Form A-5?
A: Form A-5 needs to be filled out by corporations looking to self-insure workers' compensation liabilities in California.
Q: Why would a corporation want to self-insure workers' compensation liabilities?
A: Corporations may choose to self-insure workers' compensation liabilities to have more control over their insurance costs and claims management.
Q: Is self-insuring workers' compensation liabilities allowed in other states?
A: Yes, self-insuring workers' compensation liabilities is allowed in other states, but the specific requirements may vary.
Form Details:
Download a fillable version of Form A-5 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations.