Workers compensation worker 2026

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  1. Click ‘Get Form’ to open the Termination Notice in the editor.
  2. Begin by entering the 'Requested Termination Effective Date' which indicates when the coverage will end for the client.
  3. In the 'Client Information' section, provide the business entity's legal name, FEIN (do not use SSNs), assumed business name (if applicable), and contact details including phone number and email.
  4. Select a reason for termination from the options provided. Ensure you check all relevant boxes that apply to your situation.
  5. Fill in the 'Worker Leasing Company Information' section with your company's legal name, Oregon leasing license number, and FEIN.
  6. Finally, have an authorized representative sign and date the form. Ensure their name, email, and phone number are also included.

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