New York Notice of Election of Corporation To Exclude Sole Shareholder Officer Or Executive Officers Shareholders From WC Coverage is a form that must be completed and filed with the New York State Workers' Compensation Board by a business that wishes to opt out of the coverage of workers' compensation for its sole shareholder, officer, or executive officers. This form must be filed within 30 days of the election to exclude these individuals from coverage and must include the name of the corporation, the name of the sole shareholder, officer, or executive officers, the date of election, and the signature of the corporation's authorized representative. The form must also be accompanied by a copy of a resolution of the board of directors of the corporation certifying the election. There are two types of New York Notice of Election of Corporation To Exclude Sole Shareholder Officer Or Executive Officers Shareholders From WC Coverage: 1) Notice of Election to Exclude Shareholder Employees from Coverage 2) Notice of Election to Exclude Officer/Executive Officers from Coverage.