WC Form 9 Worker's Compensation Notice of Cancellation


State: Alabama
Category: Other
Format: PDF
Form Name: 138.pdf

(The pdf reader is necessary.)

Form Instructions:

 

INSTRUCTIONS: ALABAMA NOTICE OF CANCELLATION (WC Form 9)

 

 

Businesses operating in Alabama use WC Form 8 to notify the state Department of Labor that they have purchased worker's compensation insurance as required by law. WC Form 9, which is discussed in this article, is used to notify the department of the cancellation of this policy. This document can be obtained from the website maintained by the Alabama Department of Labor.

 

Alabama Notice Of Cancellation WC 9 Step 1: On the first blank line, enter the business state unemployment compensation tax number.

 

Alabama Notice Of Cancellation WC 9 Step 2: On the second blank line, enter the federal ID number.

 

Alabama Notice Of Cancellation WC 9 Step 3: On the third blank line, enter the name of your corporation or limited liability company (LLC).

 

Alabama Notice Of Cancellation WC 9 Step 4: On the fourth blank line, enter the "doing business as" (dba) name of your company.

 

Alabama Notice Of Cancellation WC 9 Step 5: On the fifth blank line, enter the address of your primary business location.

 

Alabama Notice Of Cancellation WC 9 Step 6: On the sixth blank line, enter other locations covered in this notice.

 

Alabama Notice Of Cancellation WC 9 Step 7: On the seventh blank line, enter the nature of your business.

 

Alabama Notice Of Cancellation WC 9 Step 8: On the eighth blank line, enter your NAICS code number.

 

Alabama Notice Of Cancellation WC 9 Step 9: On the ninth blank line, enter the date of the cancellation of your workers' compensation insurance.

 

Alabama Notice Of Cancellation WC 9 Step 10: On the tenth blank line, state the reason for your cancellation of the workers' compensation insurance.

 

Alabama Notice Of Cancellation WC 9 Step 11: On the eleventh blank line, enter the policy number of the workers' compensation insurance.

 

Alabama Notice Of Cancellation WC 9 Step 12: On the twelfth blank line, enter the name of the carrier of the cancelled workers' compensation insurance policy.

 

Alabama Notice Of Cancellation WC 9 Step 13: On the thirteenth blank line, enter the NCCI code of the insurance carrier of the cancelled workers' compensation insurance policy.

 

Alabama Notice Of Cancellation WC 9 Step 14: File the form by mailing it to the address given at the top of the page.

 

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