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How to use or fill out Texas Form 84 with our platform
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Click ‘Get Form’ to open Texas Form 84 in the editor.
Begin by entering the 'Date of Joint Agreement' and 'Date of Subsequent Hiring Agreement' at the top of the form. Ensure these dates are accurate as they are crucial for record-keeping.
Fill in the 'Location of Specific Job Sites Not Affected by Joint Agreement' section. This helps clarify which job sites are exempt from the joint agreement.
Next, provide details for both the Hiring Contractor and Independent Contractor. Include names, addresses, and Federal Tax I.D. Numbers to ensure proper identification.
Both parties must sign and date the form in their respective sections. This step is essential for validating the agreement.
Finally, review all entries for accuracy before saving your completed form. Retain a copy for your records and submit it to the appropriate workers’ compensation insurance carrier within 10 days.
Start using our platform today to fill out Texas Form 84 easily and efficiently!
28 Tex. Admin. Code 110.110 - Reporting Requirements for
Form-84, filed with the Division of Workers Compensation which establishes a relationship between the parties for purposes of the Texas Workers Compensation
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