Exclusion Form For Workers Compensation

Exclusion Form For Workers Compensation - These exemption forms can only be used to attest to a government entity that an applicant requesting a permit, license or contract from. An officer may exclude himself or herself from coverage for injury or death by accident, but not for occupational disease.

An officer may exclude himself or herself from coverage for injury or death by accident, but not for occupational disease. These exemption forms can only be used to attest to a government entity that an applicant requesting a permit, license or contract from.

These exemption forms can only be used to attest to a government entity that an applicant requesting a permit, license or contract from. An officer may exclude himself or herself from coverage for injury or death by accident, but not for occupational disease.

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These Exemption Forms Can Only Be Used To Attest To A Government Entity That An Applicant Requesting A Permit, License Or Contract From.

An officer may exclude himself or herself from coverage for injury or death by accident, but not for occupational disease.

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