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Publications and Forms

Lessor Employing Units Regulation (MODES-4281)

State regulation for lessor employing units.

Missouri Public Work Check-Off List (PW-5)

A checklist for public work projects compliance.

Missouri Unemployment Tax Information for 501(c)(3) Nonprofit Corporations (MODES-INF-389)

An informational brochure regarding unemployment tax information for 501(c)(3) Nonprofit Corporations regarding exemptions, voluntary election of coverage and reporting requirements.

Motion for Leave to Withdraw (WC-236)

A motion to withdraw an attorney in regards to a workers' compensation case.

Noncompliance Referral Form (WC-258)

Complete the form to report a business for not carrying workers' compensation insurance.

Notice of Opening or Closure of Mines (LS-66)

A form to notify the Mine and Cave Safety Program when a Missouri mine or cave is opening or closing. Report Online

Project Notification - Contractor Information (PW-2)

A project notification containing contractor information.

Proposed Rates for Group Trust Self-Insurance (WC-127)

A form to submit proposed rates for a self-insured group trust.

Questions and Affidavit Regarding Benefit Sources and Payments - Affidavit Form A (WCT-2)

Questions and affidavit for claimant regarding benefit sources and payments, form A.

Questions and Affidavit Regarding Completeness of Medical Information Submitted - Affidavit Form E (WCT-6)

Questions and affidavit for claimant regarding completeness of medical information submitted, form E.