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Certificate of compliance minnesota workers compensation law 2026
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- Click ‘Get Form’ to open the certificate of compliance in our editor.
- Begin by filling in your business details. Enter your business name, telephone number, and address. Ensure that the information is accurate and printed clearly.
- Next, provide your workers' compensation insurance policy information if applicable. Fill in the insurance company name, policy number, NAIC number, effective date, and expiration date.
- If you are exempt from workers' compensation insurance, select the appropriate reason from the options provided. Be sure to explain any exclusions clearly in the designated area.
- Finally, certify that all information is accurate by signing the form. Include your title and date of signing before submitting.
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certificate of compliance minnesota workers compensation law
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