General Information
Notice of Basic Coverage Form
Notice of Basic Coverage Instructions
Non-Resident Certification Form
Non-Resident Certification Instructions
2017 HCSF Surcharge Rates
2018 HCSF Surcharge Rates
2019 HCSF Surcharge Rates
2020 HCSF Surcharge Rates
2021 HCSF Surcharge Rates
Notice of Cancellation
Request for Refund
Request for Refund Instructions
IRS Form W9 (Request for Taxpayer Identification)
Initial Claim Report Form
Initial Claim Report Instructions
Request to Increase HCSF Coverage
Request to Decrease HCSF Coverage
Self-Insured Application and Guidelines
Non-Admitted Insurer Declaration of Compliance
Non-Admitted Insurer Declaration Instructions