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Publications and Forms

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.

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.

Tramite su Petición de Seguro por Desempleo (MODES-INF-353-9-S)

Tramite su petición por Internet en cualquier momento.

Transferred Consumer Registration (MODES-5083)

The Transferred Consumer Registration is a form used by Consumer Direct Service(CDS) Providers to register program participants (consumers) that have been previously registered by different CDS Provider.

Unemployment Compensation Notice of Appeal (8-B)

A notice of appeal to the Missouri Court of Appeals.

Vivienda Justa Guía del Consumidor (MCHR-53-S)

En este folleto informativo averiguar acerca de sus derechos de vivienda justa. 

Wages, Hours and Dismissal Rights (LS-18)

RSMo chapter 290 regarding wages, hours and dismissal rights.

Work Search Record (MODES-4736)

Use this form to keep a list of all the employers and labor unions you contact each week while claiming unemployment insurance benefits.

Worker Relationship Questionnaire (MODES-4389-SF-I)

The Worker Relationship Questionnaire is completed by a business and/or worker regarding the details of the worker's Missouri services performed. Not fillable at this time.

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