Form SN004 Workers Compensation Network Acknowledgement - Texas

What Is Form SN004?

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

FAQ

Q: What is the purpose of Form SN004 Workers Compensation Network Acknowledgement?
A: The purpose of Form SN004 Workers Compensation Network Acknowledgement is to acknowledge the employee's awareness of the workers compensation network.

Q: Who is required to complete Form SN004 Workers Compensation Network Acknowledgement?
A: All employees covered by workers compensation insurance in Texas are required to complete Form SN004 Workers Compensation Network Acknowledgement.

Q: What information does Form SN004 Workers Compensation Network Acknowledgement require?
A: Form SN004 Workers Compensation Network Acknowledgement requires the employee's name, date of hire, and signature.

Q: Can Form SN004 Workers Compensation Network Acknowledgement be completed electronically?
A: Yes, Form SN004 Workers Compensation Network Acknowledgement can be completed electronically as long as it meets the electronic signature requirements in Texas.

Q: What happens if an employee refuses to sign Form SN004 Workers Compensation Network Acknowledgement?
A: If an employee refuses to sign Form SN004 Workers Compensation Network Acknowledgement, they may risk losing certain benefits under the workers compensation system in Texas.