Forms
Click on the desired form from the listing below.
BCM 250 Notice of Election to be Exempt
By filling out this application, you elect to be exempt from the provisions of chapter 440, Florida state Worker's Compensation Law, and waive any right you may have to workers' compensation benefits in the state of Florida should you become injured on the job.
BCM 217 Revocation of Certificate of Exemption of Coverage
Download this file, complete, and mail to:
Department of Labor and Employment Security
Bureau of WC Compliance
2551 Executive Center Circle, West
Suite 201 Lafayette Building
Tallahassee Florida, 32301-5014
Worksheet for Business Income and Extra Expense Coverage
This worksheet simplifies the method of determining the total income and expense exposure for your business. If your business has multiple locations, please complete one worksheet for each location.
ERM 14 Confidential Request for Change
Use this form to facilitate changes to your Workers Compensation policy regarding amendments to your business ownership.
