Reference: Ref-02941

Reference Name: Form DFS-F2-DWC-252
Agency: 69 Department of Financial Services
69L Division of Workers' Compensation

Modified Document(s):
11/26/2014 No wordding was changed, document changed to a pdf file to prevent public from using mock-up form
10/17/2019 The form has been updated to reflect the current CFO’s name and to add a divider line.
Original Document(s):
6/25/2013
Description:

Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.

Rules/Notices using this Reference Material
Notice /
Adopted
Section Description ID Publish
Date
View Text Final
69L-6.012
Notice of Election to be Exempt 15240463 Effective:
11/19/2014
View Text Final
69L-6.012
Notice of Election to be Exempt 13287465 Effective:
08/07/2013