lrforms.mo.gov Open in urlscan Pro
2a02:e980:5a::39  Public Scan

Form analysis
2 forms found in the DOM

POST https://labor.mo.gov/search-mo-gov

<form action="https://labor.mo.gov/search-mo-gov" method="post" accept-charset="UTF-8">
  <fieldset>
    <legend class="sr-only"> Search </legend>
    <div class="form-group">
      <label class="sr-only" for="edit-search">Search</label> <input name="search" class="form-control" id="edit-search" type="search" placeholder="Search" value="" autocomplete="off">
    </div>
    <button class="btn text-hide" id="btg" type="submit"> Search </button>
    <input name="form_id" type="hidden" value="mo_cms_gsa_search_form">
  </fieldset>
</form>

POST /Surcharge/login

<form id="loginModel" action="/Surcharge/login" method="post">
  <div class="col-md-3 col-lg-3">&nbsp;</div>
  <div class="col-md-6 col-lg-6">
    <div class="form-group">
      <label for="accessCode" class="control-label"> Access Code </label>
      <input id="accessCode" name="accessCode" aria-required="true" class="form-control" aria-label="Enter your Access Code" required="required" type="text" value="" maxlength="5">
    </div>
    <div class="form-group">
      <label for="idNumber" class="control-label"> ID Number </label>
      <input id="idNumber" name="idNumber" aria-required="true" type="password" class="form-control" aria-label="Enter your ID number" required="required" value="" maxlength="10">
    </div>
    <div class="form-group">
      <label for="email" class="control-label"> Email </label>
      <input id="email" name="email" aria-required="true" class="form-control" aria-label="Enter your email" required="required" type="text" value="">
    </div>
    <div class="margin-top-10">&nbsp;</div>
    <button type="submit" class="btn btn-primary btn-lg btn-block"> Login </button>
    <div class="margin-top-10">&nbsp;</div>
    <div class="margin-top-10">&nbsp;</div>
  </div>
  <div class="col-md-3 col-lg-3">&nbsp;</div>
</form>

Text Content

Missouri Department of Labor and Industrial Relations



QUICK NAVIGATION

 * Skip to Main Content
 * MO.gov
 * Gov. Mike Parson
 * Find an Agency
 * Online Services

Search
Search
Search
Mobile Menu Button



TOOLBAR LINKS

 * RSS News Feed
 * Email us
 * Watch Videos on Youtube
 * Connect with us on LinkedIn
 * Follow us on Twitter
 * Like us on Facebook

   
 * Employers
 * Injured Workers
 * Unemployed Workers
 * Discrimination
 * Public Entities
 * Forms
 * News


DIVISION OF WORKERS' COMPENSATION
SECOND INJURY FUND SURCHARGE

Electronic Partnering/Confidentiality Agreement Affidavit of Zero Reporting
(Commercial Insurers Only) Affidavit of Zero Reporting (Memorandum) Web Enabled
Filing of Second Injury Fund Surcharge Quarterly Report Forms Online Report of
Second Injury Fund Surcharge Quarterly Forms Electronic Transfer Enrollment Form
(WC-132)
 
Access Code
ID Number
Email
 
Login
 
 
 

If you need assistance, please email SIFSURCHARGE@LABOR.MO.GOV or call (573)
526-5756 or (573) 526-3505.


DIVISIONS

 * Labor Commission
 * About the Department
 * Employment Security
 * Human Rights Commission
 * Labor Standards
 * State Board of Mediation
 * Workers' Compensation


EXPLORE BY TOPIC

 * Appeals/Objections
 * Discrimination
 * Equal Opportunity
 * Mandatory Posters
 * Mine & Cave Safety
 * Minimum Wage
 * Occupational Disease
 * On-Site/SHARP
 * Prevailing Wage

 * Public Works Projects
 * Second Injury Fund
 * Tort Victims
 * Training & Presentations
 * Unemployment
 * Wages, Hours & Dismissal Rights
 * Workers' Compensation
 * Workers' Safety Program
 * Youth Employment


CONNECT WITH US

 * Twitter
 * YouTube
 * Flickr
 * LinkedIn
 * Facebook
 * Email
   
 * GovDelivery
 * RSS



Governor
Mike L. Parson

Mo.gov State of Missouri

Acting Director
Anna S. Hui


STATE OF MISSOURI NAVIGATION

 * Accessibility
 * Privacy
 * Data and Statistics
 * Labor Laws & Links
 * Report Fraud
 * Contact Us
 * Jobs
 * Translation
 * Proposed Rules
 * Labor Periodic Rule Review

Missouri Department of Labor and Industrial Relations is an equal opportunity
employer/program. TDD/TTY: 800-735-2966 Relay Missouri: 711

Back to top