Get TN LB-0090 2017
OF WORKERS’ COMPENSATION ACT OF TENNESSEE This form is to be used when an officer of a corporation elects to be exempt from the provisions of, and not be covered by, the Tennessee Workers’ Compensation Act. This election shall not become effective until 30 days have passed following the date of signature without an accident resulting in injury or death. This form is not to be filed with the Bureau of Workers’ Compensation. INSTRUCTIONS FOR THE CORPORATE OFFICER MAKING THE ELECTION: Provide.
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