ACORD 133 WI (2010/04)

Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 133 WI (2010/04)
Wisconsin Workers Compensation
Insurance Pool
ACORD 133 WI, Wisconsin Workers Compensation Insurance Pool,
is used as an application for workers compensation insurance coverage required by the
Wisconsin Workers Compensation Insurance Pool. For answers to questions about
completing this form, call the Pool at (262) 796-4592.
ACORD 133 WI (2010/04) rev. 05-28-2010
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