Notice Of Election Religious Charitable Organization Bring Executives Under NY WC {C-105.3}

C-105.3 - NOTICE OF ELECTION OF AN INCORPORATED RELIGIOUS, CHARITABLE, EDUCATIONAL, OR U.S. WAR VETERANS ORGANIZATION TO BRING EXECUTIVE OFFICERS UNDER THE COVERAGE OF THE NEW YORK WORKERS' COMPENSATION LAW. The purpose of this form is to inform the insurance carrier that the corporation has elected to bring its executive officers under the coverage of the New York Workers' Compensation Law. The form includes details about the corporation, such as its name, address, and the type of organization it is. Additionally, the form requires the names, titles, and addresses of the executive officers included in the policy. The Secretary of the corporation must certify that the election was duly made at a meeting of the corporation's board or executive body. The form must be sent to the insurance carrier, and any changes to the executive officers or revocation of the election require filing a new form. www.FormsWorkflow.com