Notice Of Coverage
Notice Of Coverage Form. This is a Alabama form and can be use in Workers Compensation.
Tags: Notice Of Coverage, WC 8, Alabama Workers Compensation,
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : WC FORM 8 Rev 6/2004 Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against- : NOTICE OF COVERAGE TO THE DEPARTMENT OF INDUSTRIAL RELATION : WORKERS’ COMPENSATION DIVISION 649 MONROE STREET SUITE 3816 : MONTGOMERY, AL 36131 Defendant(s) : ...................................................... STATE UNEMPLOYMENT COMPENSATION TAX NUMBER_________________________ FEDERAL ID NUMBER_________________________________________________________ THE PEOPLE OF THE STATE OF NEW YORK CORPORATION/LLC___________________________________________________________ TO DOING BUSINESS AS___________________________________________________________ ADDRESS_____________________________________________________________________ GREETINGS: ADDITIONAL LOCATIONS that all business and excuses being laid aside, you and each of you attend before COVERED____________________________________________ WE COMMAND YOU, , the Honorable at the Court ______________________________________________________________________________ located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed orNATURE OF BUSINESS_______________________________NAICS____________________ adjourned date, to testify and give evidence as a witness in this action on the part of the EFFECTIVE DATE OF POLICY__________________EXPIRATION DATE__________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you POLICY NUMBER______________________________________________________________ liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. INSURANCE CARRIER_________________________________________________________ Witness, Honorable Court in County, , one of the Justices of the NCCI CODE___________________________________________________________________ day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com