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Publications and Forms

Mesothelioma Liability Election of Self-Insured Employer or Group Trust Member Pursuant to 287.200.4(3), RSMo (WC-304-I)

A form used by Division authorized self-insured employers and group trust members to notify the Department of their mesothelioma liability election

Military Unemployment Benefits for Trailing Spouses (MODES-4793)

Missouri law allows spouses of active or reserve military personnel to be eligible for unemployment insurance benefits if leaving their job to relocate to be with their spouse.

Minimum Wage Complaint Form (LS-51)

A complaint form regarding Missouri minimum wage. File online today!

Missouri Department of Labor Contractors Payroll Form (LS-57)

A form to record contractor payment records on public works projects.

(NOTE: For best results, download the form and fill out using Adobe Reader instead of completing the form in the browser.)

Missouri Minimum Wage Required Poster (LS-52)

Poster to be hung in workplace regarding Missouri minimum wage.

Missouri Safety and Health Consultation Service (LS-10)

Information series regarding a no-cost confidential service for employers to help achieve OSHA compliance and increase workplace safety.

Missouri Workers' Safety Program (WSP-50)

The Missouri Workers' Safety Program helps businesses improve workplace safety and reduce workers' compensation insurance costs.  The brochure is a brief overview of the program and what they offer.  

Missouri's Second Injury Fund (WC-120)

Information regarding the Missouri Second Injury Fund.

Notice of Commencement/Termination of Compensation (WC-2)

A notice of commencement/termination of compensation to be filled out by a self-insured/self-administered employer, insurance company, or third party administrator.

Notice of Commencement/Termination of Compensation Spreadsheet (WC-2)

A notice of commencement/termination of compensation to be filled out by a self-insured/self-administered employer, insurance company, or third party administrator.

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