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Click ‘Get Form’ to open the bwc 117 ohio in the editor.
Begin with Section A, where you will update your business information. Enter your legal business name, trade name (DBA), and entity type. Ensure you provide accurate details as they appear on your current policy.
Move to Section B to update your address and contact information. Fill in the primary physical location and any mailing address if different. This is crucial for effective communication with BWC.
In Section C, if applicable, request to cancel elective coverage by providing the name of the individual and effective date of cancellation.
Proceed to Section D if you need to cancel Ohio workers’ compensation coverage. Indicate the reason for cancellation and ensure all necessary details are filled out.
Finally, complete Section F by signing and dating the form, certifying that all information is accurate before submitting it via mail or fax.
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