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Get and Sign Dfs F2 Dwc 250 Form 2013-2022
Only one box in this section):
CONSTRUCTION INDUSTRY
Corporate Officer (your corporate title: ____________________)
-ORMember of Limited Liability Company
NON-CONSTRUCTION INDUSTRY
Corporate Officer (your corporate title: ____________________)
-ORMember of Limited Liability Company
THIS REVOCATION OF ELECTION TO BE EXEMPT APPLIES ONLY TO THE PERSON NAMED ON THIS FORM
AND ONLY TO THE CORPORATION/LLC THAT IS LISTED IN THIS SECTION:
Corporation or Limited Liability Company Name:
Exemption...
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