The following applications & forms are available for downloading as PDF files:
Acord Applications
- ACORD 125 Application for Commercial Insurance
- ACORD 126 Application for Commercial General Liability
- ACORD 128 Application for Garage and Dealers
- ACORD 130 Application for Workers Compensation
- ACORD 131 Application for Umbrella/Excess
- ACORD 140 Application for Property
- ACORD 146 Application for Equipment Floater
Supplemental Applications & Forms
- Workers’ Compensation Atlas Supplemental Form (PDF)
- Direct Deposit Commission Authorization Form (PDF)
- Waiver of Subrogation Request Form (PDF)
- Electronic Payment Authorization Form (PDF)
- New Venture Supplemental Application (PDF)
- Atlas Contractors GL Supplemental Application (PDF)
- Atlas Transportation Supplemental Application (PDF)
- Atlas Amazon Supplemental Application (PDF)
States Exclusion/Inclusion Forms
- Alabama Form WC14-15 Employer Notice Include Exclude
- Arizona Employees Notice of Rejection of Terms
- California SB189 Corp Waiver
- California SB189 General Partner/Managing Member
- California SB189 Professional Corp Waiver
- Colorado Rejection of Coverage by Partners and Sole Prop Perfomong Construction Work Sites WC045 Construction Coverage Rejection TEMPORARY May 2020
- Colorado 171 CO Rejection of Coverage by Corporate Officer of members of an LLC
- Connecticut Form 6B-1-Coverage Election-Emps of Partnership
- Connecticut Form 6B-Coverage Election-Officer Manager Member
- Connecticut Form 75-Coverage Election-SProp Sing Member LLC
- Delaware Officer LCC Member Exclusion Form
- Florida Form DWC-250 Instructions Notice Election to be Exempt
- Florida Form DWC-250-Notice Election to be Exempt
- Florida Form DWC-250R Notice Revocation Election Exempt
- Florida Form DWC-251 Notice Election of Coverage
- Florida Form DWC-251-R Revocation Election of Coverage
- Iowa 14-0061 Exclusion
- Iowa Non-Election Form 14-0175
- Idaho IC52 Election of Coverage Form
- Indiana State Form 36097
- Kansas WC-113 Election of Individual
- Kansas WC-114 Cancellation of KWC113
- Kansas WC-50 Exclusion Form
- Kansas WC-50a Cancellation of KWC-50
- Louisiana Notice of Election Revocation of Coverage
- Massachusetts Form 153 Corporate Officers Exemption
- Maryland Form C-15R-Inclusion Form Sole Proprietors Partners Election Form
- Maryland WCC Exclusion Form IC-16
- Maine Form WCB-2C Application for Waiver
- Michigan Specific Person Exclusion Form
- Missouri LLC Member Rejection of Coverage for Workers Compenstion Insurance
- Missouri WC134 MO Sole Proprietor Affidavit of Exemption for Workers Compensation Insurance
- Mississippi Notice of Election Revocation of Coverage
- North Carolina Notice of Election or Rejection Form
- Nebraska Work Comp Corporate Owner Rejection and Election Form
- New Hampshire Exclusion of Executive Officers or Members
- New Jersey ACORD FORM Notice of Election Proprietors and Partners
- New Jersey Form PP-1B Notice of Election Proprietors Partners Election
- New Mexico CID Sole Proprietor Election Form
- New Mexico Election to be Subject WC Act
- New Mexico Executive Employee Affirmative Form
- New Mexico NM Revocation of Prior Election Form
- Nevada Sole Proprietor Coverage
- Nevada Rejection of Coverage Form
- New York Form C-105_32 Notice of Election of a Partnership
- New York Form C-105_51 Exclude Shareholders and Executive Officers
- New York Form C-105_52 Non for Profit Exclude Unsalaried Executive Officer
- New York Form_C-105 53 Revoke Election for Non for Profit Organization
- New York Form C-105_55 Revoke Shareholders Executive Officers Exclusion
- Pennsylvania Form LIBC 509-Application for Executive Officer Exception
- Pennsylvania Form LIBC_513 Executive Officers Declaration
- Rhode Island Corporate Exclusion Form
- South Carolina Form Corporate Officer Notice to Reject
- South Carolina Form Corporate Officer Notice To Reject
- Tennessee Form Initial WC Exemption Registration Application
- Tennessee Form I-4 Election of Sole Proprietor or Partner
- Tennessee Form_I-5 Notice of Withdrawal Sole Proprietor
- Tennessee Form I-6 Notice of Corporate Officer to Employer
- Tennessee Form I-7 Notice Corporate Officer’s Revocation of Exemption
- Tennessee Form I-8 Notice of Acceptance by Employer
- Virginia Notice Terminating Prior Rejection of Coverage
- Virginia Rejection of Coverage LLC Corporation
- Vermont Form 29 Exclude Corporate Officers Corporations Application
- Wisconsin Principle Officer Exclusion
- Wisconsin Corporate Officer Exclusion Worksheet
- West Virginia Rejection or Election Form