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Agents/Producers/Brokers

Popular Forms Complete List

Posted Date: Current
    
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PEO - Assigned Risk Forms
Learn how to accurately fill out the following frequently submitted forms by downloading a copy of the form along with the instructions.
Posted Date: October 28, 2021
PEO - Employee Leasing Forms
Learn how to accurately fill out ER Split Data hard copy reporting forms.
Posted Date: August 11, 2021
Letter of Authority Template (PDF)
The Letter of Authority Template gives authorization to an agent or carrier to access an employer’s information from NCCI.
Posted Date: Current
ERM-14—Ownership Submission
ERM-14 form is to be submitted for reporting changes in ownership, mergers, consolidations or a combination of entities.
Posted Date: Current
ERM-6 Form
ERM-6 form is used when a risk's coverage period is insured by a non-affiliate self-insurer or a non-affiliate carrier.
Posted Date: Current
Contracting Classification Premium Adjustment Program (CCPAP) Workers Compensation Premium Credit Application Forms
Provides a discount program for qualifying contractors who pay employees more than the average wage.
Posted Date: Current

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