Get Wccw Utah

Filing the Workers Compensation Coverage Waiver (Wccw) in Utah is a straightforward process. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and efficiently, ensuring you meet all necessary requirements.

Follow the steps to successfully complete the Wccw Utah online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide your business name, ensuring you use the exact or full name as registered. Indicate the years your business has been operational.
3. Enter your mailing address, including your street address or P.O. Box, city, state, and zip code. Also, provide your business telephone number and fax number if applicable.
4. List the names and street addresses of all Utah locations associated with your business. Utilize additional pages if necessary.
5. Select the type of ownership from the provided options, including sole proprietor, corporation, partnership, limited liability company, or limited partnership. Fill in your federal tax ID number.
6. List the owners, partners, or corporate officers, including their names, percentage of ownership, titles, social security numbers, and principal duties.
7. Describe the nature of your business and the operations conducted.
8. If you have had previous insurance coverage, indicate yes or no. If yes, note the policy period and provide information about the insurance company for the last three years.
9. Complete the payment section by providing your name, address, and an authorized signature. The payment of $50.00 should be made payable to the Workers Compensation Fund.
10. After filling out all sections accurately, review your entries. Once confirmed, you can save your changes, download the document, print it, or share it as needed.

Start filling out your Wccw Utah online today to ensure compliance and protect your business.