The purpose of this amendment is to update Form DWC-250, Notice of Election to be Exempt, and its instructions, so that applicants are provided an area where they may supply the Division with an e-mail address. The amendment also updates current ...

 

DEPARTMENT OF FINANCIAL SERVICES
Divsion of Worker's Compensation

RULE NO: RULE TITLE
69L-6.009: Forms and Instructions
PURPOSE AND EFFECT: The purpose of this amendment is to update Form DWC-250, Notice of Election to be Exempt, and its instructions, so that applicants are provided an area where they may supply the Division with an e-mail address. The amendment also updates current addresses for field offices of the Division of Workers’ Compensation’s Bureau of Compliance. The effect of the amendment is to expand options for communication between the Division and applicants, and update field office addresses.
SUBJECT AREA TO BE ADDRESSED: Form DWC-250, and its instructions, and field office addresses of the Division of Workers’ Compensation’s Bureau of Compliance.
SPECIFIC AUTHORITY: 440.05, 440.591 FS.
LAW IMPLEMENTED: 440.05 FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
TIME AND DATE: Thursday, July 20, 2006, 11:00 a.m.
PLACE: Room 104J, Hartman Building, 2012 Capital Circle, S. E., Tallahassee, Florida
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Andrew Sabolic, Bureau Chief, Bureau of Compliance, Division of Workers’ Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4228, [phone]
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this program, please advise the Department at least 5 calendar days before the program by contacting the person listed above.

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

69L-6.009 Forms and Instructions.

(1) No change.

(a) DWC 250 Notice of Election to be Exempt, revised 5/06 9/01; and instructions for same (Construction Industry Instructions for DWC 250, revised 9/01 and Non-Construction Industry Instructions for DWC 250, revised 2/00 Instructions for Completing Notice of Election to be Exempt, revised 5/06).

(b) through (d)  No change.

(2)  No change.

(3) The field offices of the Division of Workers’ Compensation, Bureau of Compliance, are:

 

921 North Davis Street, Building B1111 N. E. 25th Avenue, Suite 403

Suite 250Ocala, FL 34470

Jacksonville, FL 32209Telephone [phone]

Telephone [phone]

 

2012 Capital Circle, S. E.2686 Chapman Drive 

Suite 102, Hartman Bldg.Panama City, FL 32405-4914

Tallahassee, FL 32399-2161Telephone [phone]

Telephone [phone]

 

610 East Burgess Road3111 South Dixie Highway

Pensacola, FL 32504-6320Suite 123

Telephone [phone]West Palm Beach, FL 33405

Telephone [phone]

 

499 N.W. 70th Avenue12381 S. Cleveland Avenue

Suite 1164415 Metro Parkway

Plantation, FL 33317Suite 506, Suite #300,

Telephone [phone]Ft. Myers, FL 3390716

Telephone [phone]-1840

 

1313 Tampa Street1718 Main Street

Suite 503Suite 201

Tampa, FL 33602Sarasota, FL 34236

Telephone [phone]Telephone [phone]

 

400 West Robinson Street401 N.W. 2nd Avenue

Room 512, North TowerSouth Tower, Suite 321

Orlando, FL 32801Miami, FL 33128

Telephone [phone]Telephone [phone]

Specific Authority 440.05, 440.05(9), 440.10, 440.185(7), 440.42(2), 440.591, 440.593 FS. Law Implemented 440.05, 440.103, 440.185(7), (9), 440.38(2), 440.42(2), 440.593 FS. History–New 11-20-79, Amended 4-15-81, 1-2-86, Formerly 38F-6.09, Amended 5-28-91, 2-15-94, 2-2-00, 3-5-02, Formerly 38F-6.009, 4L-6.009, Amended ________.