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C 105 2  Form

C 105 2 Form

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AFTER THE DATE FILED WITH THE CHAIRMAN, WORKERS' COMPENSATION BOARD AND THE INSURANCE CARRIER. TAKE NOTICE that under the provisions of Sec.54, subd. 6, of the New York Workers' Compensation Law as amended, the municipal corporation or other political subdivision of the State named below hereby revokes, effective as provided by law, the election now in effect to bring its executive officers described herein within the coverage of the New York Workers' Compensation Law, with respect to...
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