Inclusion form 2026

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The document is an inclusion form for sole proprietors and partners to elect coverage under the Workers' Compensation Act in Maryland. It outlines the process for these individuals to opt-in for coverage, requiring them to complete and submit the form to the Workers’ Compensation Commission and their insurer.

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Click ‘Get Form’ to open the inclusion form in the editor.
Begin by entering the current date in the designated field. This is important for record-keeping.
Fill in the name of your insurance company. Ensure that this information is accurate to avoid any issues.
Next, provide your company name and complete address, including city, state, and ZIP code. This helps in identifying your business.
In the section labeled 'Name and Title of Person Electing Coverage', enter your full name and title clearly.
Finally, sign the document in the 'Personal Signature' field to validate your election for coverage.
Once completed, review all entries for accuracy before submitting. You can also click 'Clear Form' if you need to start over.

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