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WC-337 (6/09) Notice of Exclusion

This form is used to exclude certain individuals from insurance coverage as permitted by statute and is not available online.  To find out whether you qualify for this exclusion and obtain a copy of the form, contact the Compliance & Employer Records Division at (517) 322-1195.

Related Content
 •  WC-338 (7/09) Notice to Terminate Exclusion
 •  WC-400 (2/13) - Insurer's Notice of Issuance of Policy (fill-in form) PDF icon
 •  WC-400A (7/09) - Insurer's Notice of Issuance of Specific Risk Policy
 •  WC-401 (2/13) - Notice of Termination of Liability (fill-in form) PDF icon
 •  WC-401A (7/09) - Notice of Termination of Specific Risk Policy
 •  WC-403 (9/13) - Insurer's Notice of Name or Address Change (fill-in form) PDF icon
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