Surcharge Form for the period beginning July 1, 2017 and ending December 31, 2017 Forms


Form NameSurcharge Form for the period beginning July 1, 2017 and ending December 31, 2017
Form #WC113
Form RevisionRev 11/17
CategoryForms » Financial/Compensation
Downloads
Form StateColorado
LanguageEnglish
State DescriptionThis form is used by insurers to calculate applicable surcharge amounts.
Claimwire Descriptionn/a
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