Get Form09-4c.rtf. Csu-02-030207

The Form09-4C.rtf, also known as the Florida Contracting Classification Premium Adjustment Program Workers Compensation Premium Credit Application, is designed for qualifying employers in contracting operations. This guide provides clear steps for completing this form accurately online.

Follow the steps to complete the premium credit application online.

1. Click the ‘Get Form’ button to obtain the application. This will allow you to open the form in your preferred editor.
2. Begin filling out the form by entering the name of the insured in the designated field, followed by the business address, including city, state, and zip code.
3. Indicate whether your business is new by selecting 'Yes' or 'No.' If applicable, provide the effective date of your workers compensation policy.
4. If your business is not new, submit payroll information for the third calendar quarter of the previous year. If it is new, provide data for the first complete calendar quarter after your policy's effective date.
5. Complete the section regarding contracting classifications by accurately reporting total Florida wages paid and total hours worked for each classification listed, ensuring you exclude overtime premium pay and other exempt payments.
6. Review the information provided to ensure accuracy. Make sure all required fields are filled out, particularly the code(s), total wages paid, and total hours worked.
7. Sign the application, inputting your position and date of signing, to validate the information provided.
8. Once the form is complete, save your changes, and download, print, or share the application as needed for submission.

Complete your documents online now to ensure your premium credit application is submitted timely.