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DATE (MM/DD/YYY) WORKERS COMPENSATION APPLICATION AGENCY NAME AND ADDRESS COMPANY: Shearer Insurance LLP DBA Herbert M. Shearer Jr. Insurance AGY P.O. Box 140535 Dallas TX 75214 UNDERWRITER: APPLICANT
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130 xx - workers refers to a specific classification or group of workers.
Employers or individuals responsible for managing the workers classified under 130 xx are required to file.
To fill out 130 xx - workers, you must provide relevant information about the workers in that classification.
The purpose of 130 xx - workers classification is to categorize and manage a specific group of workers.
Information such as names, contact details, roles, and qualifications of the workers in the 130 xx classification must be reported.
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