Self-Insurer’s Payroll Report Forms
| Form Name | Self-Insurer’s Payroll Report |
| Form # | WC-84 |
| Form Revision | (09-19) |
| Category | Forms » Financial/Compensation |
| Downloads | |
| Form State | Missouri |
| Language | English |
| State Description | An annual report of an individually self-insured employer’s Missouri payroll by class code and employee count by Missouri location. |
| Claimwire Description | n/a |