Arkansas Non Coverage Workers Comp Withdrawal

State:
Arkansas
Control #:
AR-00A-WC
Format:
PDF
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Description

Application for Certificate of Non-Coverage

How to fill out Arkansas Instructions On Fee And Notary Statement Application For Certificate Of Non-Coverage (2-Sided) Required Notary Statement?

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FAQ

Arkansas Workers' Compensation Commission. Insurance Requirements: Most employers in Arkansas with three or more employees are required by law to have Workers' Compensation insurance coverage for their employees.

Download the Application for Certificate of Non-Coverage (Form A) at the link below. Complete the Application, have the Affidavit notarized, and decide on a payment option. Applications can be mailed, along with the notarized affidavit and a check or money order for $50, to the address at the top of the form.

Arkansas Workers' Compensation Commission. Insurance Requirements: Most employers in Arkansas with three or more employees are required by law to have Workers' Compensation insurance coverage for their employees.

How to File a Workers' Compensation Claim in Arkansas Step 1: Notify Your Employer. ... Step 2: Try Resolving the Dispute Prior to Filing Forms. ... Step 3: Find the Correct Forms & Fill Them Out. ... Step 4: File and Serve Forms. ... Step 5: Attend All Mediation, Settlement Discussions, and Hearings. ... Step 6: Filing an Appeal.

Most Arkansas businesses with three or more employees are required to carry workers' compensation insurance coverage.

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Arkansas Non Coverage Workers Comp Withdrawal