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Get NY C-105.53 2004-2024

FIT UNINCORPORATED ASSOCIATION TO EXCLUDE AN UNSALARIED EXECUTIVE OFFICER FROM COVERAGE PURSUANT TO SECTION 54, SUBDIVISION 6 OF THE WORKERS' COMPENSATION LAW To: (Print nameName and address of insuranceof carrier here) (Print and Address Insurance Carrier Here) TAKE NOTICE that under the provisions of Section 54, subdivision 6, of the New York Workers' Compensation Law as amended, the corporation or association named below hereby revokes, effective as provided by law, the election now in effe.

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