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DOL FORM 10/10s State File No.** Ins. Co. File No. Date of Injury Fed. ID No. (Rev. 9/09) DEPARTMENT OF LABOR WORKERS' COMPENSATION DIVISION CERTIFICATE OF DEPENDENCY AND EMPLOYEE EXEMPTION REPORT

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What is mywcinfo?

mywcinfo is a platform that allows users to report and manage their workers' compensation information.

Who is required to file mywcinfo?

All employers are required to file their workers' compensation information through mywcinfo.

How to fill out mywcinfo?

To fill out mywcinfo, you need to log in to the platform using your credentials and provide the necessary information about your workers' compensation coverage.

What is the purpose of mywcinfo?

The purpose of mywcinfo is to streamline the process of reporting and managing workers' compensation information for employers.

What information must be reported on mywcinfo?

On mywcinfo, employers must report details about their workers' compensation coverage, such as policy numbers, coverage start and end dates, and insurance carrier information.

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