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Publications and Forms

Application for Employment (MODOL-2396)

An application form for those seeking employment with the Missouri Department of Labor and Industrial Relations.

Application for Membership (WC-81B)

Form to be used by employers applying for membership in a group trust.

Application for Review to the Labor and Industrial Relations Commission (MOIC-2567)

An application to have an award, decision or order reviewed by the LIRC.

Applying for Unemployment Insurance Benefits (MODES-4713)

A checklist for unemployed workers on how to apply for benefits.

Are You Off the Books? 1099 Fraud - Worker Misclassification (MODES-4714)

Information related to 1099 Fraud - Worker Misclassification, including consequences, online-assessment and tip reporting.

Aviso a los trabajadores sobre las prestaciones por desempleo (MODES-B-2-S)

Un cartel para colgar en un lugar de trabajo notificar a los empleados sobre los beneficios de desempleo.

Certificate to Employ a Child 14 or 15 Years of Age During Non-School Term (LS-68)

Certificate to employ a child age 14 or 15 during summer months. 

Certificate to Employ a Child 14 or 15 Years of Age During School Term (LS-67)

Certificate to employ a child age 14 or 15 during school months.

Claim for Compensation (WC-21)

A form to be completed by the injured worker or by his or her attorney when making a claim for workers' compensation for injuries occurring prior to January 1, 2014.

Claim for Compensation (WC-21-A)

A form to be completed by the injured worker or by his or her attorney when making a claim for workers' compensation for injuries occurring on or after January 1, 2014, based upon the revisions to the Workers’ Compensation Law made by Senate Bill 1.

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