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DELAWARE WORKERS COMPENSATION ELECTION CORPORATE EXCLUSION The undersigned officer of stipulate that each named Firm Name officer holds stock in the corporation and that I/we elect to be excluded from coverage under the firm s workers compensation policy.
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How to fill out Delaware officer exclusion form:

01
Obtain the Delaware officer exclusion form from the Delaware Division of Corporations website or by contacting their office directly.
02
Provide your personal information in the designated sections of the form, such as your full name, address, and contact details.
03
Clearly state the name of the corporation or entity from which you are seeking exclusion.
04
Indicate your position within the corporation, such as officer or director, that you wish to exclude from the coverage of the Delaware General Corporation Law.
05
Sign and date the form to certify the accuracy and authenticity of the information provided.
06
Submit the completed form to the Delaware Division of Corporations by mail or in person, along with any required fees.
07
Keep a copy of the filled-out form for your records.

Who needs Delaware officer exclusion form:

01
Individuals who hold positions of authority, such as officers or directors, within a corporation registered in Delaware.
02
Those who wish to exclude their positions from the coverage of the Delaware General Corporation Law.
03
Individuals seeking to maintain confidentiality or limit liability for certain corporate actions or decisions.
Please note that it is advisable to consult with a legal professional or the Delaware Division of Corporations to ensure accurate completion of the form and to understand the specific requirements and implications of filing for officer exclusion.
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Delaware officer exclusion form is a form used to exclude officers from workers' compensation coverage in the state of Delaware.
Business owners or officers who are not covered by workers' compensation insurance must file the delaware officer exclusion form.
The delaware officer exclusion form can be filled out online through the Delaware Department of Labor website or submitted by mail.
The purpose of delaware officer exclusion form is to officially exclude officers from workers' compensation coverage and responsibilities.
The delaware officer exclusion form requires information such as the officer's name, position, company information, and reason for exclusion.
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