ACORD 133MI Instructions


 

Section Name Field Name Field and/or Section Description
Use this form to apply for Workers’ Compensation insurance to the Michigan Workers’
Compensation Placement Facility. Instructions for completing this application can be
found in the Michigan Workers’ Compensation Placement Facility’s Information and
TITLE Michigan Application for Workers’ Procedures Handbook. This handbook is available from the Michigan Worker’s
ACORD 133 MI (2009/02) Compensation Insurance Compensation Placement Facility or at www.caom.com.