Get Si 12 2020-2025
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How to fill out the Si 12 online
The Si 12 form, known as the Affidavit Certifying that Compensation has Been Secured, is essential for businesses to demonstrate that they have secured workers' compensation insurance coverage. This guide will help you navigate filling out the Si 12 online with ease and confidence.
Follow the steps to complete the Si 12 online successfully.
- Click the ‘Get Form’ button to obtain the Si 12 form and open it in your preferred editing interface.
- Begin by entering the name of the business that has secured workers' compensation insurance coverage in the designated field.
- In the next section, indicate the manner in which the business is self-insured by selecting one of the options provided, referencing relevant sections of the Workers’ Compensation Law.
- Specify the effective date when the self-insurance status commenced in the appropriate field.
- Ensure that you provide a clear signature and date in the 'In Witness Whereof' section, confirming the information submitted.
- Once all fields are completed, review your entries for accuracy and completeness. Make any necessary corrections.
- Save changes to the Si 12 form. You may also choose to download, print, or share the completed document as needed.
Start filling out your Si 12 form online today to secure your workers' compensation insurance coverage.
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