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  • Fl Dwc 250 2004

Get Fl Dwc 250 2004

Myfloridacfo. com/wc DWC 250-R NOTICE OF REVOCATION OF ELECTION TO BE EXEMPT - REVISED 11/11 RULE 69L-6. 009 F.A. C. SUBMIT THIS FORM TO THE DISTRICT OFFICE LISTED BELOW THAT IS CLOSEST TO YOUR PLACE OF BUSINESS 2295 Victoria Avenue Suite 163 Ft. STATE USE ONLY Effective/Issue Date NOTICE OF REVOCATION OF ELECTION TO BE EXEMPT Control Number Postmark Date Received Date PLEASE TYPE OR PRINT I hereby revoke the exemption I currently have as a check only one box in this section CONSTRUCTION INDUSTRY Corporate Officer your corporate title Member of Limited Liability Company -OR- NON-CONSTRUCTION INDUSTRY THIS REVOCATION OF ELECTION TO BE EXEMPT APPLIES ONLY TO THE PERSON SIGNING THE REVOCATION AND ONLY TO THE CORPORATION/LLC THAT IS LISTED IN THE FOLLOWING SECTION Corporation or LLC Name Business Mailing Address County City Phone No* State FEIN Zip Corporate registration number Scope of Business or Trade of Applicant Listed on Notice of Election to be Exempt You must identify the workers c....

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How to fill out the FL DWC 250 online

The FL DWC 250 is a critical form for revoking an election to be exempt from workers' compensation coverage. Completing this form online can simplify the process and ensure your information is submitted accurately and efficiently.

Follow the steps to successfully complete the FL DWC 250 online.

  1. Click 'Get Form' button to obtain the form and open it in your editor.
  2. Carefully read the section to select your current exemption category. Choose between 'Construction Industry' or 'Non-Construction Industry' by checking the appropriate box.
  3. For both categories, if you select 'Corporate Officer,' be sure to type your corporate title in the designated field.
  4. Fill in the corporation or LLC name where prompted, ensuring the name captured is accurate.
  5. Provide your business mailing address, including county, city, state, and zip code. Make sure all fields are filled in completely to avoid processing delays.
  6. Enter your phone number, including the area code, in the provided format.
  7. List your Corporate registration number and Federal Employer Identification Number (FEIN) to ensure proper identification of your business.
  8. Identify the scope of your business or trade by listing all relevant activities in the spaces provided. Be clear to detail activities that are significant to your operation.
  9. Document the name of your workers’ compensation insurance carrier covering any non-exempt employees. This is crucial for compliance with state regulations.
  10. After filling all required fields, review your information for accuracy. Make corrections as needed.
  11. Type or print your name in the space provided, and ensure you sign the form with the date when submitting.
  12. Finally, you may save your changes, download, print, or share the form as necessary.

Complete your FL DWC 250 online today for seamless processing of your revocation.

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Get FL DWC 250
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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
FL DWC 250
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