Election of Workers' Compensation Coverage for Certain Employees under the Workers' Compensation Act OR Revocation of Previous Election of Such Coverage Forms
| Form Name | Election of Workers' Compensation Coverage for Certain Employees under the Workers' Compensation Act OR Revocation of Previous Election of Such Coverage |
| Form # | 6B-6B-1-75 Directions |
| Form Revision | Rev. 12-15-2022 |
| Category | Jurisdiction Guides/Notices » Jurisdiction Guides/Notices |
| Downloads | |
| Form State | Connecticut |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |