How to use or fill out revocation of election form with our platform
- Click ‘Get Form’ to open the revocation of election form in the editor.
- Begin by entering the effective/issue date at the top of the form. This is crucial for record-keeping.
- In the section labeled 'I hereby revoke the exemption I currently have as a', select one option that applies to you: either 'Construction Industry' or 'Non-Construction Industry'. If applicable, provide your corporate title.
- Fill in the corporation or LLC name, business mailing address, county, city, phone number, state, FEIN, zip code, and corporate registration number in the designated fields.
- List the scope of business or trade related to your exemption in the provided spaces. Be specific to ensure clarity.
- Identify your workers’ compensation insurance carrier by entering their name in the specified field.
- Finally, type/print your name and sign where indicated. Ensure you include the date signed for validation.
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What is form 5768 for?
How to revoke as election?
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