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VA VWC 61-A 2017 free printable template

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Contractors Certificate of Workers Compensation InsurancePLEASE COMPLETE FULLY AND LEGIBLY RETURN TO:(Form 61A)www.workcomp.virginia.govElectronic Filing Available Online Name of Business Owner /ContractorVirginia
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How to fill out VA VWC 61-A

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How to fill out 2024 form va vwc

01
Obtain a copy of the 2024 form va vwc.
02
Read the instructions provided on the form carefully.
03
Fill in all the required information accurately and legibly.
04
Double-check the form for any errors or missing information before submitting.
05
Submit the completed form as instructed by the Virginia Workers' Compensation Commission.

Who needs 2024 form va vwc?

01
Individuals in Virginia who have suffered a work-related injury or illness and are seeking workers' compensation benefits.

Who Needs VOC Form 61-A?

VOC Form 61-A is officially called Contractor’s Certificate of Worker’s Compensation Insurance. It is widely used by contractors and businesses that perform their work in the Virginia state. Out of state employers must have valid Virginia coverage.

What is VOC Form 61-A for?

Generally, Certificate of Insurance is issued to provide information about worker’s insurance policy coverage to the party that has requested it. As an informative document it is rather limited in ability. Its main aim is to help companies or individuals who are hiring contractors to relieve responsibility for injuries and damages that may occur during work. With Contractor’s Certificate companies make sure that they will not be liable for possible damages. This certificate doesn’t guarantee any changes to the insurance policy, neither it bestowed nor extends the rights of the policyholder.

Is VOC Form 61-A Accompanied by Other Forms?

No additional documents are required to be attached to the certificate.

When is VOC Form 61-A due?

As the certificate serves informative purpose there is no specific due date for it. It is filled out upon request.

How Do I Fill out VOC Form 61-A?

VOC Form 61-A consists of one fillable page accompanied by instructions. In total there are fifteen fillable fields. The first one must be completed by the official issuing business license. Starting from the second field and up to the end of the Form 61-A, all information is provided by the contractor. The information includes business owner’s or contractor’s name, address, phone number, mail address that is used by the business to receive mail by the U.S. Postal Service. It is also mandatory to indicate the type of trade in which business is classified and its VEIN.  

Where Do I Send VOC Form 61-A?

Completed Form 61-A is sent to the local office where business license was obtained.

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You may file the claim: In person: Complete the Claim for Benefits Form and deliver it to any of our office locations. By mail: Complete the Claim for Benefits Form and mail it to: Virginia Workers' Compensation Commission, 333 E. By fax: Complete the Claim for Benefits Form and fax it to: 804-823-6956.
Certificate of Workers' Compensation Insurance (Form 61A)
Proof of coverage shall include the name and address of the insured, the insured's federal employer identification number (FEIN), the policy number, dates of insurance coverage, the name and address of the insurer, and the insurer's identification number.
1 Q: Am I required to obtain workers' compensation insurance? A: Virginia law requires that an employer who regularly employs more than two part-time or full-time employees carry workers' compensation.

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Form VA VWC 61-A is a form used by the Virginia Workers' Compensation Commission to report work-related injuries or illnesses.
Employers in Virginia are required to file form VA VWC 61-A when an employee experiences a work-related injury or illness.
Form VA VWC 61-A can be filled out online on the Virginia Workers' Compensation Commission website or submitted via mail.
The purpose of form VA VWC 61-A is to document and report work-related injuries or illnesses for workers' compensation purposes.
Form VA VWC 61-A requires information such as the employee's name, the nature of the injury or illness, the date it occurred, and details about medical treatment.
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