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Nh 6wcex Form

Nh 6wcex Form

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6WCex form. A copy of this form shall be sent to each executive officer or members listed below by certified mail. 1. Date Effective date of Exclusion CARRIER INFORMATION Carrier No* Carrier Name and Address AGENT INFORMATION Agent Name and Phone Number EMPLOYER INFORMATION Employer Federal ID No* Employer Name and Address 2. EXCLUDED OFFICERS OR MEMBERS Specific title must be provided* If a corporation President Vice President Treasurer or Secretary. If Limited Liability Co. member social...
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Instructions and help about new hampshire 6wcex form

my name is Andrew Demers I am the communications director at the New Hampshire insurance department I'm joined by several of my colleagues from here at the insurance department and a couple of folks from the Department of Labor namely Deputy insurance commissioner DJ Bettencourt director of Workers Compensation Division at the New Hampshire Department of Labor Danielle Albert attorney at the New Hampshire Labor Department of Labor Wesley Gardner my colleagues roju Davi who's a workers compensation analyst here at the insurance department and Christian citarella our chief Property and Casualty actuary at the insurance department though we're very happy to to partner with the Department of Labor as you'll learn during the webinar workers compensation is something that both of our departments touch in various aspects and there's a number of areas where we cross over here so we're very excited to be participating with our folks at the Department of Labor before we get started with the prog

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