Premium Audit Forms
Florida
The Workers’ Compensation Quarterly Self-Audit Report is provided for Florida policyholders to remain in compliance with state statutes. Florida policyholders must use this form to submit their quarterly earnings to Summit at the end of each quarter.
Florida Quarterly Self-Audit Form and Instructions
State unemployment and federal reporting forms
Please see below for links to state unemployment and federal reporting forms. Some states are not available.
Arkansas Employer’s Quarterly Contribution and Wage Report
Florida Employer’s Quarterly Report
Georgia Employer’s Quarterly Tax and Wage Report – DOL4N
Mississippi Employer’s Quarterly Wage Report – Form UI-3
North Carolina Employer’s Quarterly Tax and Wage Report