Form LIC04 Certificate of Compliance - Minnesota Workers' Compensation Law - Minnesota

What Is Form LIC04?

This is a legal form that was released by the Minnesota Department of Labor and Industry - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form LIC04?
A: Form LIC04 is a certificate of compliance for the Minnesota Workers' Compensation Law in Minnesota.

Q: What is the purpose of Form LIC04?
A: The purpose of Form LIC04 is to certify that an employer has workers' compensation coverage as required by law.

Q: Who needs to fill out Form LIC04?
A: Employers in Minnesota who have workers' compensation coverage need to fill out Form LIC04.

Q: Is Form LIC04 mandatory?
A: Yes, Form LIC04 is mandatory for employers in Minnesota with workers' compensation coverage.

Q: What information is required on Form LIC04?
A: Form LIC04 requires information about the employer's business name, address, policy number, and the effective and expiration dates of the workers' compensation coverage.

Q: Is there a fee for submitting Form LIC04?
A: No, there is no fee for submitting Form LIC04.

Q: Is there a deadline for submitting Form LIC04?
A: There is no specific deadline for submitting Form LIC04, but it should be filled out and submitted as soon as the employer acquires workers' compensation coverage.