Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas

Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas

What Is Form DWC005?

This is a legal form that was released by the Texas Department of Insurance - Division of Workers' Compensation - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form DWC005?
A: Form DWC005 is the Employer Notice of No Coverage or Termination of Coverage in Texas.

Q: When is the Form DWC005 used?
A: The Form DWC005 is used when the employer does not have workers' compensation insurance coverage or when the coverage is terminated.

Q: What information does the Form DWC005 require?
A: The Form DWC005 requires the employer's name, address, FEIN/SSN, contact information, and details about the coverage status.

Q: How do I submit the Form DWC005?
A: The Form DWC005 can be submitted electronically or by mail to the Texas Division of Workers' Compensation.

Q: What are the consequences of not submitting the Form DWC005?
A: Failure to submit the Form DWC005 may result in penalties and legal consequences for the employer.

ADVERTISEMENT

Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the Texas Department of Insurance - Division of Workers' Compensation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form DWC005 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance - Division of Workers' Compensation.

Download Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas

4.4 of 5 (27 votes)
  • Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas

    1

  • Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas, Page 2

    2

  • Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas, Page 3

    3

  • Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas, Page 1
  • Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas, Page 2
  • Form DWC005 Employer Notice of No Coverage or Termination of Coverage - Texas, Page 3
Prev 1 2 3 Next
ADVERTISEMENT

Related Documents