Notice Of Cancellation
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Notice Of Cancellation Form. This is a Alabama form and can be use in Workers Compensation.
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Tags: Notice Of Cancellation, WC 9, Alabama Workers Compensation,
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___________________________________________________________________
