ACORD 133 NJ (2013/07)

Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 133 NJ (2013/07)
New Jersey Workers
Compensation Insurance Plan -
Application For Designation of an
Insurance Company
ACORD 133 NJ, New Jersey Workers Compensation Insurance
Plan, Application for Designation of Insurance Company, is the application for Workers
Compensation Insurance coverage required by the Compensation Rating and Inspection
Bureau of New Jersey.
For instructions on the completion of this form, refer to ACORD 132 NJ, New Jersey
Workers Compensation Insurance Plan, Instructions and Rules.
ACORD 133 NJ (2013/07) rev. 06-28-2013
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