Current through Register Vol. 48, No. 5, May 24, 2024
Section 67-402 - Corporate Officer Rejection of the ActA. A corporate officer may reject the Act by taking the following action: (1) The corporate officer shall complete and file with the employer's insurance carrier a Form 5, Corporate Officer Notice to Reject.(2) The effective date of rejection is the effective date listed on the Form 5, no sooner than the day following the day the corporate officer signed the form.(3) The corporate officer shall provide notice to the employer of the rejection of the Act by giving a copy of the Form 5, personally, to the employer or its agent or by sending it by registered or certified mail to the employer or its agent.B. An insurance carrier or self-insured fund may substitute its own form for the Form 5. Any substitute form must: (1) Include substantially the same information included on the Form 5, including information that advises the corporate officer of the effects of rejecting the Act; and(2) Require the corporate officer's signature be notarized.Amended by State Register Volume 21, Issue No. 4, eff April 25, 1997.