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Commonwealth of Virginia | Governor

Claimant Registration | Login
Form 61A - Certificate of Workers' Compensation Insurance
Important Message

For guidance to commonly reported issues, please click here.

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NOTE: If you are using MS Edge you may experience problems preventing the Acknowledgement Letter from appearing when you have completed the 61A process. In order to resolve this MS Edge issue, you may need to choose another browser or you may need to use a different PDF viewer application and change your default PDF viewer to a compatible application such as Adobe Acrobat Reader DC, Foxit Reader, Sumatra PDF, or any other PDF viewer.

Here's how to change your default PDF reader in Windows 10:
  • Go to Start > Settings
  • Within the Settings app head to Apps > Default apps
  • Click on Choose default apps by file type and change the app association of the PDF file extension with an application of your choice (This can be another browser or a third-party PDF reader.)
The following links contain additional information on updating the default PDF reader:
You will need your policy information/declaration page to complete this form. If this is not available to you, you will need to contact your agent/broker to obtain your policy number as it was filed with NCCI, the five digit NCCI carrier code assigned to the insurance carrier you are insured with and the effective and expiration date of your policy.

For Workers' Compensation Insurance Information for employers click here.