New York Revocation of Election of Corporation To Exclude Sole Shareholder Or Executive Officers From WC Coverage is a form that employers in New York State must complete in order to revoke the election to exclude sole shareholders and executive officers from workers' compensation coverage. This form must be completed when the sole shareholder or executive officer ceases to be an employee of the company, or if the employer wishes to revoke the election for any other reason. There are two types of New York Revocation of Election of Corporation To Exclude Sole Shareholder Or Executive Officers From WC Coverage forms: one for an individual sole shareholder, and one for multiple sole shareholders or executive officers. Both forms must be notarized and submitted to the New York Workers’ Compensation Board in order to be approved.