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- Click ‘Get Form’ to open the md wcc form ic 02 2010 in the editor.
- Begin by checking the appropriate box that represents your status as a covered employee. You can choose from options regarding your election under Section § 9-227 and whether you have employees.
- Fill in your name as the sole proprietor, along with your Social Security Number or Federal Employer Identification Number (FEIN) in the designated fields.
- Provide your complete address, including street, city, state, and ZIP code to ensure accurate identification.
- Indicate the effective date and expiration date for which this representation is valid.
- Finally, sign and date the form at the bottom to affirm that all information provided is true to the best of your knowledge.
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