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Iate rating organization. Submit the completed form to the rating organization. PURPOSE (Check One) Name change only Complete column A for former entity and column B for newly named entity Complete only questions 1, 2 and 3 on page 2 Combination of separate entities Complete a separate column for each entity related through common ownership (attach additional forms if necessary) Sale, Transfer or conveyance of ownership interest Complete column A for ownership before the change and column B for.

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The ERM-14 Form may be submitted via online application or PDF for reporting changes in ownership, mergers, consolidations, or a combination of entities. Submit Your Experience Rating Ownership Request Online—including electronic signature!

The ERM-14 form is used to request ownership information and may be used in a variety of instances, including when there has been a change in ownership, when an entity needs to be added later or when multiple entities need to be considered for combinability.

The ERM-14 Form may be submitted via online application or PDF for reporting changes in ownership, mergers, consolidations, or a combination of entities. Submit Your Experience Rating Ownership Request Online—including electronic signature! Other Options: ERM-14 Form Instructions (PDF)

Why is the ERM-14 form necessary? to the state for proof of coverage reporting. If the employer's name or entity type has changed, the proof of insurance coverage may not get reported accurately. As a result, the employer may receive a letter from the state asking for proof of coverage.

The ERM-14 form is used to request ownership information and may be used in a variety of instances, including when there has been a change in ownership, when an entity needs to be added later or when multiple entities need to be considered for combinability.

The ERM-14 is a confidential form completed by the insured and submitted to the NCCI for the purpose of assisting the various workers' compensation bureaus to verify coverage and determine combinability of entities as it relates to premium calculation.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232