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Workers Compensation Form 61A. Click the “next” button to continue to the “owner/contractor’s information” section. Click here to complete the form and receive your acknowledgement of compliance.
Virginia workers’ compensation commission attention: Enter the complete name of business. Web go to the 61a form website at: Return this form to the licensing authority. Web electronic filing of the contractor certification form 61a is now available. Click here to file the certificate of workers' compensation insurance (form 61a) online. Certificate of workers' compensation insurance (form 61a) | virginia workers' compensation commission All information requested is required. Click the “next” button to continue to the “owner/contractor’s information” section. Change in condition claims response form.
Return this form to the licensing authority. Click here to file the certificate of workers' compensation insurance (form 61a) online. Click here to complete the form and receive your acknowledgement of compliance. Enter the complete name of business. The completed form assists the commission in following up with uninsured contractors that may be required to insure under the act. Click the “next” button to continue to the “owner/contractor’s information” section. Franklin street richmond, va 23219 name of business owner /contractor last:. Return this form to the licensing authority. Enter the business owner / contractor’s name, mailing address and phone number, all information is required. Virginia workers’ compensation commission attention: All information requested is required.
