Alabama > Workers Compensation
Notice Of Cancellation WC 9 - Alabama
| Notice Of Cancellation Form. This is a Alabama form and can be used in Workers Compensation . |
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WC FORM 9 Rev. 4-2003 NOTICE OF CANCELLATION TO THE DEPARTMENT OF INDUSTRIAL RELATIONS WORKERS COMPENSATION DIVISION 649 MONROE STREET SUITE 3816 MONTGOMERY, AL 36131STATE UNEMPLOYMENT COMPENSATION TAX NUMBER_________________________FEDERAL ID NUMBER_________________________________________________________CORPORATION/LLC___________________________________________________________DOING BUSINESS AS__________________________________________________________ADDRESS_____________________________________________________________________ADDITIONAL LOCATIONS COVERED__________________________________________________________________________________________________________________________NATURE OF BUSINESS_____________________________NAICS______________________DATE OF CANCELLATION__________________________REASON____________________POLICY NUMBER______________________________________________________________INSURANCE CARRIER__________________________________________________________NCCI CODE___________________________________________________________________
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