Fillable blank contractors liability insurance certification 2012 form

1-3714 Code of Virginia. Form 61 A is available online at www. Return this form to the licensing authority. Signature of Applicant Date Print Name of Applicant Form 61-A is prepared and distributed by the Virginia Workers Compensation Commission to local licensing authorities for use in compliance with 58. Contractor s Certificate of Workers Compensation Insurance Form 61-A www....
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VWC 61-A Form Versions

Version Form Popularity Fillable & printable
VWC 61-A 2014 5.0 Satisfied
(56 Votes)
VWC 61-A 2012 4.0 Satisfied
(42 Votes)
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