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243-1002 ELECTION OF SOLE PROPRIETOR OR PARTNER TO COME WITHIN THE PROVISIONS OF THE TENNESSEE WORKERS' COMPENSATION LAW FORM EFFECTIVE 30 DAYS AFTER TENNESSEE DEPARTMENT OF LABOR'S ACCEPTED STAMP DATE. ORIGINAL TO BE SENT TO THE DIVISION OF WORKERS' COMPENSATION WITH ALL PARTS FILLED OUT AND PROPERLY SWORN TO BEFORE NOTARY PUBLIC OR OTHER OFFICIAL. To the Workers' Compensation Director: You are hereby notified that the undersigned Type or Print Name being a ( ) Sole proprietor ( ) Member ( ).

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Keywords relevant to Form I4

  • elects
  • workforce
  • herein
  • notary
  • expires
  • Proprietor
  • duly
  • Provisions
  • Nashville
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