Get the free Form WC-113A. Multiple Carrier Redemption Form
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PrintResetMULTIPLE CARRIER REDEMPTION FORM Michigan Department of Labor and Economic Opportunity Workers Disability Compensation Agency PO Box 30016, Lansing, MI 48909 PlaintiffEmployerSocial Security
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How to fill out form wc-113a multiple carrier
How to fill out form wc-113a multiple carrier
01
Obtain form WC-113a multiple carrier from the appropriate agency or website.
02
Fill in the required information for each carrier involved in the workers' compensation claim.
03
Provide details of each carrier's coverage, policy number, and contact information.
04
Double-check the form for accuracy and completeness before submission.
Who needs form wc-113a multiple carrier?
01
Employers or insurance companies involved in a workers' compensation claim with multiple carriers.
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What is form wc-113a multiple carrier?
Form WC-113a multiple carrier is a form used to report multiple carriers involved in a workers' compensation claim.
Who is required to file form wc-113a multiple carrier?
Insurance companies or self-insured employers who are involved in a claim with multiple carriers are required to file form WC-113a multiple carrier.
How to fill out form wc-113a multiple carrier?
Form WC-113a multiple carrier should be filled out with the necessary information about each carrier involved in the claim, including their contact information and policy details.
What is the purpose of form wc-113a multiple carrier?
The purpose of form WC-113a multiple carrier is to provide a clear and concise report of all carriers involved in a workers' compensation claim.
What information must be reported on form wc-113a multiple carrier?
Information such as carrier names, addresses, policy numbers, and contact information must be reported on form WC-113a multiple carrier.
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