Missouri Affidavit of Zero Reporting - Commercial Insurers Only

State:
Missouri
Control #:
MO-SKU-2154
Format:
PDF
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Description

Affidavit of Zero Reporting - Commercial Insurers Only

The Missouri Affidavit of Zero Reporting — Commercial Insurers Only is a form used by commercial insurers in the state of Missouri to certify that they have no workers' compensation liabilities to report. This affidavit must be completed and submitted to the Missouri Department of Insurance, Financial Institutions and Professional Registration (DIP) annually. It must be signed by an authorized officer of the company. There are two types of Missouri Affidavit of Zero Reporting — Commercial Insurers Only: the original form and a revised form. The original form is used for new insurance policies and the revised form is used for existing policies. Both forms require the insurer to provide information about their policies, including the policy number, the date of issuance, the effective date, the expiration date, and the total premium. The insurer must also certify that they have no workers' compensation liabilities to report.

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Missouri Affidavit of Zero Reporting - Commercial Insurers Only