Notice Of Cancellation {WC 9} | Pdf Fpdf Doc Docx | Alabama

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Notice Of Cancellation {WC 9} | Pdf Fpdf Doc Docx | Alabama

Notice Of Cancellation {WC 9}

This is a Alabama form that can be used for Workers Compensation.

Alternate TextLast updated: 4/28/2006

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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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