- A. Description: Used to document the payment of workers’ compensation insurance premiums. Information includes an interdepartmental transfer for payment of premiums; a form to the State Workers’ Compensation Fund reflecting the total amount due and payment due date with attached memos; and a Workers’ Compensation Insurance Quarterly Report reflecting the code, agency, source of funds, total salaries for the quarter, amount of payment due, totals, certified correct and authorizing signatures.
- B. Retention: 3 years; destroy.
HISTORY: Added by State Register Volume 17, Issue No. 6, eff June 25, 1993.