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General Services Agency

HEALTH CARE SECURITY ORDINANCE (HCSO) - ANNUAL REPORTING FORM 2013



Employers covered by the Health Care Security Ordinance (HCSO) must submit the HCSO 2013 Annual Reporting Form by April 30, 2014. Failure to do so shall constitute a violation of §14.3 (b) of Chapter 14 of the San Francisco Administrative Code. Violators shall be subject to a penalty of $500 per quarter until the Form is submitted.

Please note that you will not be able to save this form and return to it later. Before you begin, carefully read the Instructions and review the information you will need to complete the form.

If you need additional assistance, call (415) 554-7892.

Enter your Business Registration Certificate Number and click "Validate.” This number can be found on the business registration certificate(s) issued by the San Francisco Treasurer & Tax Collector, on the letter recently mailed to you about submitting this Form, or on the San Francisco Data website.
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Please note that San Francscio is transitioning to using 7-digit Business Registration Certificate numbers. If you have a 6-digit number, please add a zero at the beginning of that number.

Business Registration Certificate Number          


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