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Publications and Forms

Shared Work: An Alternative to Laying Off (MODES-4786)

Information regarding the Shared Work Program relating to employers and employees.

Showing of Interest Signature Form (SBM-09)

A list to be completed by employees naming their exclusive bargaining representative.

Showing of Interest Signature Form - Decertification Petition Only (SBM-10)

A list to be completed by employees decertifying their exclusive bargaining representative.

Statement of Specific and Aggregate Excess Insurance Coverage (WC-121)

Proof of initial, renewal, or changes to specific and aggregate Missouri only excess insurance coverage.

Survivors' Benefits: For Family Members of Missouri's Fallen Workforce (WCLoD-15)

A brochure outlining the benefits provided by the Missouri Workers’ Compensation Law in the event of a compensable fatal accident or fatal occupational disease.

The Job Match-Up (MODES-4789)

A flyer providing information on how to plan an effective work search.

Tort Victim Petition for Review to the LIRC (T-2568)

A petition for review by the LIRC of a decision made by a workers compensation administrative law judge.

Unemployment Claim Request for Assistance (MODES-4605)

A form to be completed when you need assistance with unemployment claim information from the Division of Employment Security. 

Unemployment Compensation Notice of Appeal (8-B)

A notice of appeal to the Missouri Court of Appeals.

Unemployment Tax Registration (MODES-2699-5)

The Division uses the Unemployment Tax Registration to determine whether an entity is liable for unemployment tax as a new or successor employer. The form must be completed even if the entity is not liable so that the Division can follow up at a time when liability may have been achieved or eliminate the entity from further follow-ups.