-2258 http://www.wcc.state.md.us INCLUSION FORM SOLE PROPRIETORS/ PARTNERS ELECTION FORM Pursuant to the provisions of Title 9, § 9-219 and § 9-227 of the Annotated Code of Maryland, sole proprietors and partners are excluded from coverage under the Workers’ Compensation Act of Maryland. Such persons may elect to become covered employees under the Workers’ Compensation Act of Maryland. To exercise this option, any sole proprietor or partner wishing to be a covered employee must sign this .
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How to fill out the MD C-15R online
The MD C-15R is an important form for sole proprietors and partners in Maryland who wish to elect coverage under the Workers’ Compensation Act. This guide will provide you with clear instructions on how to fill out this form online, ensuring that you complete each section accurately.
Follow the steps to complete the MD C-15R online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the current date in the designated field. Ensure that the date reflects when you are submitting the form.
- Indicate the date when the insurance company was notified about your election for coverage. This is important for record-keeping and verification.
- Fill in the name of the insurance company with which you are affiliated. This information is necessary for the Workers’ Compensation Commission.
- Complete the company name, address, city, state, and ZIP code sections accurately to avoid delays in processing your election.
- Provide your name and title in the relevant fields to clearly identify who is electing for coverage.
- Input your social security number in the specified field. Ensure this information is entered correctly for processing.
- Sign the form in the designated space to authenticate your election for coverage under the Workers’ Compensation Act.
- After filling out the form, review all entries for accuracy. Once confirmed, you can save changes, download, print, or share the form as needed.
Complete your MD C-15R form online today and ensure you are covered.
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