Rejection Of Coverage By Corporate Officers Or Members Of Limited Liability Company With Instructions {WC43}

WC43 - REJECTION OF COVERAGE FOR CORPORATE OFFICERS OR LIMITED LIABILITY COMPANY (LLC) MEMBERS AND CONSTRUCTION INDUSTRY PARTNERS OR SOLE PROPRIETORS. This form is used by business owners in Colorado to reject workers' compensation insurance coverage. Specifically, it applies to corporate officers, members of limited liability companies (LLCs), construction industry partners, and sole proprietors who want to voluntarily elect not to participate in the workers' compensation insurance program. The form includes several sections where the business must provide details such as its legal name, federal employer identification number (FEIN), and the identities of individuals rejecting coverage, including their role (officer, member, partner, or sole proprietor), ownership percentage, and personal identification details. It also includes a section where each individual rejecting coverage must sign a statement acknowledging the legal implications, including limited recovery rights if injured on the job. www.FormsWorkflow.com