Alabama > Workers Compensation
Notice Of Coverage WC 8 - Alabama
| Notice Of Coverage Form. This is a Alabama form and can be used in Workers Compensation . |
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WC FORM 8 Rev 10/2012 NOTICE OF COVERAGE TO THE DEPARTMENT OF LABOR DIVISION 649 MONROE STREET SUITE 3816 MONTGOMERY, AL 36131 STATE UNEMPLOYMENT COMPENSATION TAX NUMBER_________________________ FEDERAL ID NUMBER__________________________________________________________ CORPORATION/LLC____________________________________________________________ DOING BUSINESS AS___________________________________________________________ ADDRESS______________________________________________________________________ ADDITIONAL LOCATIONS COVERED____________________________________________ NATURE OF BUSINESS_______________________________NAICS____________________ EFFECTIVE DATE OF POLICY__________________EXPIRATION DATE_______________ POLICY NUMBER______________________________________________________________ INSURANCE CARRIER_________________________________________________________ NCCI CODE___________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com
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