Md Wcc Form Ic 02 PDF Details

Md Wcc Form Ic 02 is a document used to report taxes and wages withheld from an employee's paycheck. This document is also used to report any taxable income and deductions made by the employee during the year. The form must be filed with the state of Maryland by April 15th of each year. To ensure that all information is reported accurately, it is important to understand what is required on the form. For more information on completing Md Wcc Form Ic 02, please visit our website or contact one of our specialists today. You can also download a copy of the form from our website.

This article contains specifics of md wcc form ic 02. It is worth finding the time to read this before you begin filling out your form.

QuestionAnswer
Form NameMd Wcc Form Ic 02
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesic 02 form, md sole proprietor, maryland state sole proprietor, md wcc ic form

Form Preview Example

WORKERS' COMPENSATION COMMISSION

SOLE PROPRIETOR’S STATUS AS A COVERED EMPLOYEE FORM

I hereby represent to the Maryland Workers’ Compensation Commission that I am a sole proprietor doing business in and about the State of Maryland, and that on the date set forth below my signature, under the penalty of perjury, the following checked box represents my status as a covered employee.

Check all that apply:

I have elected to become a covered employee under § 9-227 of the Labor and Employment Article, Annotated Code of Maryland, and have submitted the requisite Inclusion form (IC-

15R) with the Workers’ Compensation Commission.

I have not elected to become a covered employee under § 9-227 of the Labor and Employment Article, Annotated Code of Maryland.

I understand that if I were to hire an employee(s), I must obtain workers’ compensation insurance for the employee(s).

Name of Sole Proprietor:

Social Security Number or Federal

Employer Identification Number (FEIN)

Address:

Street

 

 

City

State

Zip Code

I AFFIRM UNDER THE PENALTY OF PERJURY THAT THE FOREGOING INFORMATION IS TRUE

TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF FOR THE FOLLOWING PERIOD:

 

THROUGH

.

 

 

 

 

(Effective date)

(Expiration date)

Signature

Date

10 East Baltimore Street w Baltimore, Maryland 21202-1641

410-864-5100Email:info@wcc.state.md.usWeb:http://www.wcc.state.md.us

MD WCC Form IC-02 (12/2015)

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