PDF
Word
Form WC-403 Insurer's Notice of Name or Address Change - Michigan
What Is Form WC-403?
This is a legal form that was released by the Michigan Department of Labor and Economic Opportunity - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WC-403?
A: Form WC-403 is the Insurer's Notice of Name or Address Change in Michigan.
Q: What is the purpose of Form WC-403?
A: The purpose of Form WC-403 is to notify the Michigan Workers' Compensation Agency of a change in the insurer's name or address.
Q: Who needs to file Form WC-403?
A: The insurer is responsible for filing Form WC-403 when there is a change in their name or address.
Q: Is there a deadline for filing Form WC-403?
A: Yes, Form WC-403 must be filed within 10 days of the change in the insurer's name or address.
Form Details:
- Released on August 1, 2019;
- The latest edition provided by the Michigan Department of Labor and Economic Opportunity;
- 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 WC-403 by clicking the link below or browse more documents and templates provided by the Michigan Department of Labor and Economic Opportunity.
Download Form WC-403 Insurer's Notice of Name or Address Change - Michigan
1
2
