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Get NY C-105.41 2004-2024

ON OF THE STATE TO BRING EXECUTIVE OFFICERS UNDER THE COVERAGE OF THE NEW YORK WORKERS' COMPENSATION LAW. To: CHAIRMAN, WORKERS' COMPENSATION BOARD To: (Print (Print nameName and address of insuranceof carrier here) and Address Insurance Carrier Here) THIS REVOCATION IS EFFECTIVE 30 DAYS AFTER THE DATE FILED WITH THE CHAIRMAN, WORKERS' COMPENSATION BOARD AND THE INSURANCE CARRIER. TAKE NOTICE that under the provisions of Sec.54, subd. 6, of the New York Workers' Compensation Law as amended, th.

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