NOTICE OF CANCELLATION OR REINSTATEMENT OR ENDORSEMENT Forms
| Form Name | NOTICE OF CANCELLATION OR REINSTATEMENT OR ENDORSEMENT |
| Form # | FORM I-2 / LB-0004 |
| Form Revision | (REV.12/07) |
| Category | Forms » Insurance |
| Downloads | |
| Form State | Tennessee |
| Language | English |
| State Description | Proof of Coverage (POC) Information that must be submitted electronically to a vender that is IAIABC certified and approved by the Workers' Compensation Division. The National Council on Compensation |
| Claimwire Description | n/a |