Fla. Admin. Code Ann. R. 69L-6.009 - Forms and Instructions
Current through Reg. 47, No. 249; December 28, 2021
(1)
The following forms are hereby incorporated by reference for use in connection
with these rules:
(a) DWC 250 Notice of
Election to be Exempt, (eff. 12/08); and instructions for same (Instructions
for Completing Notice of Election to be Exempt, (eff. 12/08).
(b) DWC 250-R Revocation of Election to be
Exempt, (eff. 12/08).
(c) DWC 251
Notice of Election of Coverage, (eff. 12/08).
(d) DWC 251-R Revocation of Election of
Coverage, (eff. 12/08).
(e) DWC
252, Certificate of Election to be Exempt, (eff. 1/08).
(2) The forms may be obtained from the Bureau
of Compliance, Division of Workers' Compensation website at: www.fldfs.com/WC/
or from any field office, unless otherwise limited to direct issuance by the
Division.
(3) The field offices of
the Division of Workers' Compensation, Bureau of Compliance, are:
| 921 North Davis Street, Building B | 1111 N. E. 25th Avenue, Suite 403 |
| Suite 250 | Ocala, FL 34470 |
| Jacksonville, FL 32209 | Telephone (352) 401-5350 |
| Telephone (904) 798-5806 | |
| 2012 Capital Circle, S. E. | 3111 South Dixie Highway |
| Suite 106, Hartman Bldg. | Suite 123 |
| Tallahassee, FL 32399-2161 | West Palm Beach, FL 33405 |
| Telephone (850) 413-1609 | Telephone (561) 837-5716 |
| 610 East Burgess Road | 4415 Metro Parkway |
| Pensacola, FL 32504-6320 | Suite #300 |
| Telephone (850) 453-7804 | Ft. Myers, FL 33916 |
| Telephone (239) 938-1840 | |
| 499 N.W. 70th Avenue | Live Oak Business Center |
| Suite 116 | 5969 Cattlemen Lane |
| Plantation, FL 33317 | Sarasota, FL 34232 |
| Telephone (954) 321-2906 | Telephone (941) 329-1120 |
| 1313 North Tampa Street | 401 N.W. 2nd Avenue |
| Suite 503 | South Tower, Suite 321 |
| Tampa, FL 33602 | Miami, FL 33128 |
| Telephone (813) 221-6506 | Telephone (305) 536-0306 |
| 400 West Robinson Street | |
| Suite N 512, North Tower | |
| Orlando, FL 32801 | |
| Telephone (407) 835-4406 or (407) 245-0896 |
Notes
The following state regulations pages link to this page.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.