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Get Rejection Of Coverage (form 16a) - Virginia Workers '' Compensation ...
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How to fill out the Rejection Of Coverage (Form 16A) - Virginia Workers' Compensation online
Filling out the Rejection Of Coverage (Form 16A) is crucial for officers of corporations or managers of limited liability companies opting out of workers' compensation coverage. This guide provides clear and user-friendly instructions to assist you in completing the form accurately online.
Follow the steps to successfully complete the form online.
- Click the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
- Ensure you are using the most recent version of the Rejection Of Coverage form. It is advisable to obtain the latest version to avoid any issues during processing. Old versions will not be accepted.
- Fill in the corporation or LLC name as registered with the State Corporation Commission. This should match the charter or operating agreement of your organization.
- Complete all sections related to the officer or manager rejecting coverage, ensuring that no fields are left blank as missing information will prevent the form from being processed.
- Sign and date the form in the specified blanks. Both the signature of the officer/manager and the employer are required, even if they are the same individual.
- Provide contact information for an agent or agency to receive a copy of the approval if needed. Ensure all details are filled out accurately.
- Review the completed form carefully for accuracy before submitting it. Once finished, you can save any changes, download the form, print it, or share it as needed.
Start completing your Rejection Of Coverage (Form 16A) online today.
A worker must file a claim for workers' compensation benefits within two years of the date of accident. For most occupational diseases, you must file a claim within two years of the date you were told the disease was caused by your work and within five years of the date you were last exposed at work.
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