This form is to be used when an employer wishes to authorize a third-party representative to access all or part of their employer account as defined by the scope of representation.
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View the 2024 premium rate for the G12 - Elementary and Secondary Education rate code.
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View the 2024 premium rate for the U31 - Electric Systems rate code.
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View the 2024 premium rate for the U11 - Telecommunications rate code.
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View the 2024 premium rate for the T61 - Commercial Air Transportation rate code.
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View the 2024 premium rate for the T51 - Operation of Railways rate code.
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View the 2024 premium rate for the T42 - Transportation, Courier, Commercial Bus rate code.
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View the 2024 premium rate for the S41 - Engineering, Testing and Surveying rate code.
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View the 2024 premium rate for the S33 - Caretaking, Park Authorities rate code.
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View the 2024 premium rate for the S32 - Personal, Business and Leisure Services rate code.
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View the 2024 premium rate for the S23 - Hotels, Motels, Taxis rate code.
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View the 2024 premium rate for the S22 - Restaurants, Catering, Dry Cleaning rate code.
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View the 2024 premium rate for the S21 - Community and Social Services rate code.
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View the 2024 premium rate for the S12 - Offices, Professionals rate code.
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View the 2024 premium rate for the S11 - Legal Offices, Financial, Drafting rate code.
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View the 2024 premium rate for the R11 - Road Construction and Earthwork rate code.
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View the 2024 preliminary premium rate for the M94 - Iron and Steel Fabrication rate code.
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View the 2024 premium rate for the M92 - Machine Shops, Manufacturing rate code.
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View the 2024 premium rate for the M91 - Agricultural Equipment rate code.
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View the 2024 premium rate for the M81 - Metal Foundries and Mills rate code.
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