Cdn cocodoc cocodoc-form-pdfpdfMICHIGAN APPLICATION FOR WORKERS COMPENSATION INSURANCE 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with the 'General Information' section. Fill in the employer's name, federal employer identification number, and contact details accurately.
3. Complete the 'Legal Status' field by selecting the appropriate option that describes your business structure.
4. In the 'Insurance Record' section, indicate whether you have had previous workers’ compensation coverage and provide necessary details if applicable.
5. List all business principals in Section III, including their names, titles, duties, and approximate annual salaries.
6. For premium calculation in Section IV, describe your business operations thoroughly and provide payroll information as required.
7. Finally, review the 'Employer’s Agreement' section for compliance statements and ensure all signatures are included before submission.

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