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Get Form 807
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How to fill out the Form 807 online
Filling out Form 807 is essential for individuals or entities seeking coverage information related to a pending workers’ compensation claim. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to successfully complete Form 807
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Provide the required information regarding the pending workers' compensation claim. This includes the name of the injured worker, date of injury, claim number (if known), and WCAB number (if assigned). Ensure all details are accurate and complete, as incomplete information will delay processing.
- Fill out the requesting party information section. Print the name of the individual requesting information, their title or position, company or injured worker represented, telephone number, and the address. If this is being filled by an attorney, indicate the party represented.
- In the coverage information requested section, list both the physical address and the P.O. Box address if applicable. Ensure that the employer's address matches the policy record, as the WCIRB cannot provide coverage information otherwise.
- Check the appropriate boxes in the certification section to confirm the requesting individual's authority to access the information. The requesting party must acknowledge that the information will be used solely in connection with the pending workers’ compensation claim.
- Enter the payment amount based on the fee chart provided. Include your payment method — if you are a WCIRB member or TPE, indicate that billing is preferred, or if using a check, ensure it is enclosed with the form.
- Sign and date the form, ensuring that the signature is from an authorized individual. Review the entire form for accuracy before submission.
- Submit the completed form by mailing it to the WCIRB at the address listed on the form. If you opted for email delivery, ensure that the email address is provided.
Complete your Form 807 online today to streamline your workers’ compensation coverage research.
Yes, Michigan provides an eFile form for taxpayers. This allows for easier submission of state tax returns and can expedite processing. You can access eFile forms through the Michigan Department of Treasury website or through approved tax software. For a comprehensive overview, US Legal Forms can direct you to the necessary resources.
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