| Missouri Department of Labor and Industrial Relations

Application for Authority to Self-Insure (WC-81)

The application to be completed by an employer applying to individually self-insure.

Application for Consultation Service Form (LS-25)

An application for a Missouri On-Site Safety and Health Consultation. Fill out an application online here.

Application for Group Self-Insurance (WC-81A)

The application to be completed by a group of employers applying to form a self-insured group trust.

Auditing Procedures for Applicants for Individual Self-Insurance (WC-130-AI)

The safety auditing procedures for those employers applying to individually self-insure.

Authorization for Release of Confidential Information (WC-249-3)

An authorization for release of confidential information that must accompany the Irrevocable Letter of Credit (WC-249).

Bond of Employer Carrying His Own Risk (WC-82B)

A Surety Bond; one of three options available to meet the self-insurance security requirement.

Checklist for Individual Self-Insurance Applications (WC-128)

The checklist of required items and information that must accompany the Application for Authority to Self-Insure (WC-81).

Child Labor Complaint Form (LS-53)

A form to submit a complaint about child labor.

Classifying Employees for Unemployment Insurance Tax Purposes (MODES-INF-310)

Information for employers regarding classifying employees for unemployment insurance tax purposes.

Disaster Unemployment Assistance (DUA) Information for Filing a Claim (MODES-DUA-16)

If you are unemployed due to the disaster, you need to file a claim for regular unemployment insurance (UI) benefits.

Search Forms & Publications

Search by form number, title, or keyword

Filter by Division

Filter by Type

Filter by Topic

Items per page

Frequently Requested Forms

Claim for Compensation (Workers' Comp.)
Quarterly Contribution and Wage Report (Employment Security)
Contribution & Wage Adjustment Report (Employment Security)
Disability Schedule and Benefit Limits (Workers' Comp.)
Certificate to Employ a Child 14 or 15 Years of Age During School Term
Certificate to Employ a Child 14 or 15 Years of Age During Non-School Term
Missouri Minimum Wage Poster
Request for Mediation (Workers' Comp.)
Request for Pre-Hearing (Workers' Comp.)
Information for Workers (Employment Security)
Employers' Rights and Responsibilities (Employment Security)

How to fill and sign a PDF form

1. Open a PDF document in Adobe Acrobat DC. If you don’t have the latest version of Adobe Acrobat DC, download it for free from Adobe’s site: https://get.adobe.com/reader/

2. Click the “Fill & Sign” tool in the right pane.

3. Fill out your form: Complete form by clicking a text field and typing or adding a text box. You can add checkmarks and fill in radio buttons too.

4. Sign your form: Click “Sign” in the toolbar at the top of the page. Then draw, type, or choose an image for your signature. Then click “Apply” to place your signature on the form.

5. Send your form: After you have filled the form, you can save the PDF and send it to others.

Note: When you save a form with a signature or initials, you will no longer be able to edit the existing form fields.

By Division

Explore By Topic