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Form ICA4402 Uninsured Employer Complaint Form - Arizona
What Is Form ICA4402?
This is a legal form that was released by the Industrial Commission of Arizona - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ICA4402?
A: Form ICA4402 is the Uninsured Employer Complaint Form in Arizona.
Q: What is the purpose of Form ICA4402?
A: The purpose of Form ICA4402 is to file a complaint against an employer who does not have workers' compensation insurance in Arizona.
Q: What information is required on Form ICA4402?
A: Form ICA4402 requires information about the complainant, including their name, contact information, and details about the uninsured employer.
Q: What happens after I submit Form ICA4402?
A: After you submit Form ICA4402, the Industrial Commission of Arizona will investigate the complaint and take appropriate actions.
Q: Is there a deadline for filing Form ICA4402?
A: Yes, there is a deadline for filing Form ICA4402. It should be filed within one year from the date of the injury or discovery of the uninsured status of the employer.
Q: Are there any fees associated with filing Form ICA4402?
A: No, there are no fees associated with filing Form ICA4402.
Form Details:
- Released on August 1, 2016;
- The latest edition provided by the Industrial Commission of Arizona;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form ICA4402 by clicking the link below or browse more documents and templates provided by the Industrial Commission of Arizona.
