Assessment Reporting

Notice to Insurers using the Board’s fillable Quarterly Report:

The form is designed to treat an entry on line 2, 3 or 4 as a credit - numbers entered on these lines are calculated as negative without a negative sign. If you enter a negative sign (hyphen) the form will ADD the amount instead of deducting it from the gross employer premium base. Please check your forms before you calculate payments and submit to the Board. If you have any questions, please contact Jan Adams.

FillableReport (PDF) Quarterly - FY 2024 3rd Quarter

FillableReport (PDF) Quarterly - FY 2024 2nd Quarter

FillableReport (PDF) Quarterly - FY 2024 1st Quarter

Fillable Annual Reconciliation (PDF) - FY 2023 Note: Annual Reconciliation forms must be signed by the company's or association's chief financial officer. Electronic signatures are permissible.

Fillable Quarterly Report (PDF) - FY 2023 4th Quarter

Fillable Quarterly Report (PDF) - FY 2023 3rd Quarter

Fillable Quarterly Report (PDF) - FY 2023 2nd Quarter

Fillable Quarterly Report (PDF) - FY 2023 1st Quarter

Fillable Annual Reconciliation (PDF) - FY 2022 Note: Annual Reconciliation forms must be signed by the company's or association's chief financial officer. Electronic signatures are permissible.

Fillable Quarterly Report (PDF) - FY 2022 4th Quarter

Fillable Quarterly Report (PDF) - FY 2022 3rd Quarter

Fillable Quarterly Report (PDF) - FY 2022 2nd Quarter

Fillable Quarterly Report (PDF) - FY 2022 1st Quarter

Fillable Annual Reconciliation (PDF) - FY 2021 Note: Annual Reconciliation forms must be signed by the company's or association's chief financial officer. Electronic signatures are permissible.

Fillable Quarterly Report (PDF) - FY 2021 4th Quarter

Fillable Quarterly Report (PDF) - FY 2021 3rd Quarter

Fillable Quarterly Report (PDF) - FY 2021 2nd Quarter

Fillable Quarterly Report (PDF) - FY 2021 1st Quarter

Fillable Annual Reconciliation (PDF) - FY 2020 Note: Annual Reconciliation forms must be signed by the company's or association's chief financial officer. Electronic signatures are permissible.

Fillable Quarterly Report (PDF) - FY 2020 4th Quarter

Fillable Quarterly Report (PDF) - FY 2020 3rd Quarter

Fillable Quarterly Report (PDF) - FY 2020 2nd Quarter

Fillable Quarterly Report (PDF) - FY 2020 1st Quarter