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Get and Sign New York Liability Sole Form
(Print
namename
and address
of insuranceof
carrier
here)
THIS ELECTION IS EFFECTIVE
AS OF THE DATE FILED WITH
THE INSURANCE CARRIER
TAKE NOTICE that under the provisions of Sec. 54, subd. 8, of the New York Workers' Compensation Law as amended, the partnership
as defined in Section 10 of the Partnership Law of New York State or the limited liability partnership (LLP) or professional limited liability
partnership (PLLP) or limited liability company (LLC) or professional limited liability...
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