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Form Legal ICA4401 Uninsured Employer Complaint Form - Arizona
What Is Form Legal ICA4401?
This is a legal form that was released by the Industrial Commission of Arizona - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the purpose of the ICA4401 Uninsured Employer Complaint Form?
A: The ICA4401 Uninsured Employer Complaint Form is used to report employers who do not have workers' compensation insurance in Arizona.
Q: Who can file an ICA4401 Uninsured Employer Complaint Form?
A: Any employee who believes their employer does not have workers' compensation insurance can file the form.
Q: What information should I include in the ICA4401 Uninsured Employer Complaint Form?
A: You should provide details about your employer, your employment, and any evidence of the lack of workers' compensation insurance.
Q: What happens after I file an ICA4401 Uninsured Employer Complaint Form?
A: The Industrial Commission of Arizona will investigate the complaint and take appropriate actions, which may include penalties for the uninsured employer.
Form Details:
- Released on January 6, 2017;
- The latest edition provided by the Industrial Commission of Arizona;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form Legal ICA4401 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Industrial Commission of Arizona.
