Get Dbpr El 4504 - Quarterly Report Form - Myfloridalicense.com

Filling out the DBPR EL 4504 - Quarterly Report Form is a crucial task for companies to remain compliant with Florida regulations. This guide provides clear, step-by-step instructions for completing the form online, ensuring thorough and accurate reporting.

Follow the steps to complete the DBPR EL 4504 form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred digital environment.
2. Indicate the appropriate quarter for which the report is being filed by checking the corresponding box.
3. The Chief Executive Officer (CEO) or their equivalent must read the CEO Statement section and provide their signature and date to certify compliance.
4. The Chief Financial Officer (CFO) or their equivalent should attach the necessary documents as requested and sign and date the CFO Statement.
5. The Controlling Person must review and certify the information by signing and dating the Controlling Person Statement section.
6. Complete Page 3 of the form, including all names of controlling persons, details of any insurance plans offered, and any disputed premiums or unpaid payroll taxes.
7. Attach a copy of all required workers' compensation certificates, ensuring the certificates indicate proper coverage for the current quarter and provide the necessary cancellation notifications.
8. Complete and attach Form DBPR EL-4522, the Quarterly Compliance Form, as part of your submission.
9. After reviewing all entries for accuracy, save your changes, and you may choose to download, print, or share the completed report as necessary.

Ensure your compliance by completing your DBPR EL 4504 form online today!