LEVY REGISTRAIONEMPLOYER DETAILSEmployer NamePostal AddressLocationPhone NumberYour EmailFaxManagerDirectorOwnerBusiness DetailsBusiness License (MCR)Registration Number MCILNature of BusinessDate of Commencement of BusinessDate Wages first paid (payable)Number of WorkersIf previously registered as an employer with ACC,please state the followingACC NumberStatus of payment of LevySelect An OptionUp to date1 month behind2 month behind3 month behind6 month behind12 month behindOther relevant informationSubmit Form