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This version of the form is not currently in use and is provided for reference only. Download this version of
Form WCB-4A
for the current year.
Form WCB-4A Consent Between Employer and Employee - Maine
What Is Form WCB-4A?
This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is a Form WCB-4A?
A: Form WCB-4A is a Consent Between Employer and Employee form used in Maine.
Q: What is the purpose of Form WCB-4A?
A: The purpose of Form WCB-4A is to document the agreement between an employer and employee regarding workers' compensation benefits.
Q: Who uses Form WCB-4A?
A: Both employers and employees use Form WCB-4A.
Q: What information is required on Form WCB-4A?
A: Form WCB-4A requires information such as the names of the employer and employee, the date of the agreement, and the details of the workers' compensation benefits being agreed upon.
Form Details:
- Released on March 24, 2022;
- The latest edition provided by the Maine Workers' Compensation Board;
- 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 WCB-4A by clicking the link below or browse more documents and templates provided by the Maine Workers' Compensation Board.
