Get Form Pe601 09

This guide provides a comprehensive overview of how to complete the Form Pe601 09 online, which is necessary for notifying the Workers' Compensation Insurance Rating Bureau of California about changes in ownership and combinability of entities. Follow the instructions carefully to ensure accurate submissions.

Follow the steps to successfully complete the Form Pe601 09 online.

1. Click the 'Get Form' button to access the online version of Form Pe601 09 and open it in your preferred document editor.
2. Begin by filling out Part A, Section I, which requires contact information of the party submitting the form. Include the printed name, title, signature, date, company name, mailing address, and contact details.
3. Optionally complete Section II with the employer or policyholder’s contact information, including name, address, and contact details.
4. In Section III, check the appropriate box to indicate the reason for submitting the form, either for a change in ownership or combinability of entities. Ensure to follow-up with the corresponding sections.
5. If applicable, complete Part B to provide details regarding the change in ownership. Answer all questions regarding the nature, date of ownership change, and relationships between the buyer and seller.
6. For each entity that underwent a change in ownership, provide required details such as legal names, addresses, ownership interests, insurer information, and federal identification numbers.
7. If necessary, fill out Part C if entities should be combined or separated, providing explanations and relevant details as required.
8. After ensuring all sections are complete, save your changes in the document, then print the form for signature.
9. The authorized individual must sign the printed form. Once signed, you may choose to fax, email, or mail the completed form to the specified addresses.

Complete your Form Pe601 09 online now to ensure your ownership change or entity combinability is processed efficiently.