Information regarding employees who wish to be exempt from workers' compensation law because of religious reasons.


This form allows employees to provide proper written notification to their employer when a workplace injury/occupational disease occurs.


The form to be completed by an employee who is requesting a rescission from a previously received religious exemption.


A self-evaluation questionnaire to be completed by an unemployed claimant.


A sample of by-laws that may be used as a reference when forming a new group trust.


Certification procedures for a self-insured group trust’s safety program.


Employers use the Social Security Number Correction form to correct the social security number of an employee whose number was erroneously reported. Employers may correct the social security number of one employee on each correction form, but the form may be applicable to more than one calendar quarter. After making the correction, please return to:


Division of Employment Security

Attn: Employer Accounts Unit

P. O. Box 59

Jefferson City, MO 65104-0059

or it can be faxed to 573-751-9705.

This application is to be completed by an employer that would like to request termination of coverage. Please see the form to learn the necessary qualifications for your specific employer type. This form is effective January 1st and must be filed by February 10th of the year with respect to which the termination is to be effective.


Information about Trade Adjustment Assistance for workers who have lost their job due to foreign trade.


This document is used by employers reporting quarterly contribution and wage information via magnetic media. It lists all the information necessary for the submission and processing of the quarterly magnetic media reports. Effective January 1, 2008, the Division will not accept quarterly unemployment insurance wages on a tape cartridge. Effective July 1, 2012, the Division will not accept quarterly unemployment insurance wages on diskette. Wages may be submitted on the Internet or on a compact disc.