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Form WC-106 Supplemental Report of Fatal Injury - Michigan
What Is Form WC-106?
This is a legal form that was released by the Michigan Department of Labor and Economic Opportunity - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WC-106?
A: Form WC-106 is the Supplemental Report of Fatal Injury used in Michigan.
Q: When is Form WC-106 used?
A: Form WC-106 is used in cases where there has been a fatal injury.
Q: Who is required to complete Form WC-106?
A: Form WC-106 should be completed by the employer or insurance carrier.
Q: What information is included in Form WC-106?
A: Form WC-106 includes details about the fatal injury and the deceased individual.
Q: Are there any fees associated with submitting Form WC-106?
A: There are no fees associated with submitting Form WC-106.
Form Details:
- Released on August 1, 2019;
- The latest edition provided by the Michigan Department of Labor and Economic Opportunity;
- 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 WC-106 by clicking the link below or browse more documents and templates provided by the Michigan Department of Labor and Economic Opportunity.
