Download PDF


Employers, complete this form for access to the new Insurance Administration System (IAS). 

Please email the completed, signed form to Do not mail. If you cannot email, please fax to 608-266-5801.

If you would like to complete the form electronically, be sure to first download the form, complete using Acrobat Reader, and save.

Note: ETF is unable to assist with Adobe Acrobat Reader technical or compatibility issues. If you need assistance, please visit Adobe’s help site.