Ga 4 workers comp 2026

1. Click ‘Get Form’ to open the GA-4 Workers Comp form in the editor.
2. Begin by filling out the Municipal Self-Insurer Information section. Enter your WCB Identification Number, the full name of your municipal self-insured employer, and your FEIN. Ensure that the mailing address is complete for all correspondence.
3. In the Reporting Period section, specify the calendar year and quarter ending date. This information is crucial for accurate assessment.
4. Proceed to the Basis for Assessment section. Here, input payroll class codes, descriptions, quarterly payroll dollars, and loss costs per hundred dollars of payroll. Calculate total loss costs by multiplying quarterly payroll by loss cost rates.
5. Complete the Certification section by signing and dating the form. Include your title, printed name, phone number, and email address to finalize your submission.

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