Texas Mutual Insurance Company - Providers of Workers' Comp Insurance

Forms

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Forms Format  
Agency Online Self-Administration Form DOC  
Agency Summary Report DOC PDF
Agent W9 and new agency profile PDF
Agent's Request for Endorsement DOC PDF
Book of Business DOC PDF
Coverage Options for Corporate Executive Officers DOC PDF
Executive Supervisor Questionnaire (5606) DOC PDF
Independent Contractor Questionnaire DOC PDF
Installment Billing Guide PDF
Ownership Changes - ERM-14 ONLINE
Preferred Method of Communication PDF
Professional Employer Organization Client-Maintained Coverage Form DOC PDF
Professional Employer Organization New Client Form DOC PDF
Professional Employer Organization Questionnaire DOC PDF
Professional Employer Organization Requirements DOC PDF
Start Program Supplemental Application DOC PDF
Supplemental Application Aircraft Operations Information DOC PDF
Supplemental Application Longshore and Harbor Workers' Compensation Act DOC PDF
Supplemental Application Jones Act PDF
Supplemental Application Outer Continental Shelf DOC PDF
Supplemental Employee Data Worksheet DOC PDF
Temp Employee Data Worksheet & Client List DOC PDF
Trucking Industry Questionnaire DOC PDF
DWC-81, Agreement Between General Contractor and Subcontractor to Provide Workers' Compensation Insurance PDF
DWC-82, Agreement Between Motor Carrier and Owner Operator to Provide Workers' Compensation Insurance Coverage / Agreement to Require Owner Operator to Act as Employer PDF
DWC-83, Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers / Agreement to Establish Employer-Employee Relationship for Certain Building and Construction Workers PDF
DWC-84, Exception to Application of Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers PDF
DWC-85, Agreement Between General Contractor and Subcontractor to Establish Independent Relationship PDF

More forms on the Web

For more forms related to workers' compensation insurance or general workplace issues, visit the appropriate agency's website, listed below.


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