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ACORD Form 181 KS Kansas Cancel. Election of Coverage for Persons Performing Public Service Instructions

 

 
Section Name Field Name Field and/or Section Description
Use this form to notify the Kansas Division of Workers Compensation that an employer
cancels a previous election to provide workers compensation coverage for persons
Kansas Cancellation of Election of performing public or community service as a result of a contract of diversion, assignment
TITLE Coverage for Persons Performing to a community corrections program or suspension of sentence or as a condition of
ACORD 181 KS (2005/11) Public Service probation or in lieu of a fine.

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