Alabama exclude form 2026

1. Click ‘Get Form’ to open the Alabama exclude form in the editor.
2. In Part I, enter your full name where indicated. If you choose to be excluded from coverage, check the appropriate box and sign the form, including the date and your title.
3. If you wish to revoke your exemption and accept coverage, complete the second section of Part I by entering your full name again, checking the inclusion box, signing, dating, and providing your title.
4. Move to Part II if applicable. Here, enter your full name if you are a sole proprietor or part of a partnership. Sign and date this section as well.
5. Fill in your business name, mailing address, physical location, FEIN, UC number, WC insurance carrier details, policy number, effective date, and agency/phone information.
6. Ensure all fields are completed accurately before saving or exporting your document for submission.

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