NonSubscriber – Compliance Package
This is a copy of Texas Department of Insurance change notice
dated September 24, 2012.
We have enclosed the forms that are so vital in maintaining your status as a
Non-Subscriber in the state of Texas. They include:
1. The DWC Form-005 (Rev. 01/13) that you must complete
annually between February 1st and April 30th.
Complete and send in to the state by Certified Mail, return
receipt requested. You can now file your DWC Form 5 on-line:
https://txcomp.tdi.state.tx.us/TXCOMPWeb/nonsubscriber/DW
C5NonSecure.do?startWizard=Y&isBackAllowed=N . Texas
Department of Insurance is now requiring effective dates be
listed in Section I; Question 1. Effective date must be May 1st
of current year and expiration date April 30th of next year.
2. The DWC Form-7 that you need to complete to report any
claims. Send in monthly, only if there were injuries that
resulted in lost time in excess of the date of the injury.
3. The “Notice to Employees” that you must have all current
employees sign. All employees must sign this form when they
are hired and then placed in their personnel file.
4. The posters that are required to be posted “in an area frequented
by the employees”. The “Notice to Employees concerning
Workers’ Compensation in Texas” must be posted in both
English and Spanish and any other appropriate language.
DWC005
DWC005 Rev. 01/13 Page 1 of 3
Texas Department of Insurance
Division of Workers’ Compensation
7551 Metro Center Drive, Suite 100 • MS-96
Austin, TX 78744-1645
(800) 372-7713 phone • (512) 804-4146 fax
Employer Notice of No Coverage or Termination of Coverage
Online submission available through Employer Online Filings at:
https://txcomp.tdi.state.tx.us/TXCOMPWeb/common/home.jsp
I. REQUIRED STATEMENTS
1. Statement of No Coverage
The employer named below DOES NOT HAVE workers’ compensation insurance coverage, pursuant to the
Texas Workers’ Compensation Act, Texas Labor Code, Section 406.004.
The employer named below HAS TERMINATED workers’ compensation insurance coverage, pursuant to the
Texas Workers’ Compensation Act, Texas Labor Code, Section 406.007.
Policy terminated effective (mm/dd/yyyy):
Policy number:
Insurance company name:
Insurer informed of termination on (mm/dd/yyyy):
Employees were (will be) notified on (mm/dd/yyyy):
The election selected above is effective from (mm/dd/yyyy) to (mm/dd/yyyy). The effective
dates cannot exceed a one-year period.
2. Statement of Reportable Injuries or Diseases
Did you have any death, injury that resulted in the injured employee’s absence from work for more than one day,
or knowledge of an occupational disease since your last Employer Notice of No Coverage or Termination of
Coverage?
Yes No If your response is “Yes”, you may be required to file a DWC Form-007, Employer’s Report of
Non-covered Employee’s Occupational Injury or Disease. (See the Frequently Asked Questions section of this form.)
II. PRIMARY EMPLOYER INFORMATION
3. Employer Business Name
4. Federal Employer ID Number
5. Employer Business Mailing Address (Street or PO Box, City, County, State, Zip Code)
6. Employer Business Type
7. Six-Digit NAICS Codes
NOTE: You must provide name, Federal Employer ID number and address of each Texas business location, subsidiary, or
separate entity of the primary employer covered by this report. To identify additional locations, submit a DWC Form-205,
Locations of Employer’s Business(es).
III. PERSON PROVIDING INFORMATION
8. Printed Name
9. Phone Number
10. Title
11. E-mail Address
12. Signature 13. Date of Signature (mm/dd/yyyy)
For TDI-DWC Use Only
DWC005
DWC005 Rev. 01/13 Page 2 of 3
Frequently Asked Questions
Employer Notice of No Coverage or Termination of Coverage
Who must file the DWC Form-005?
An employer who does not have workers’ compensation insurance (non-subscriber) must file the DWC
Form-005, unless the employer’s only employees are exempt from coverage under the Texas Workers’
Compensation Act (for example, certain domestic workers, certain farm and ranch workers).
An employer who terminates workers’ compensation insurance coverage must file the DWC Form-005.
Failure to file the form when required may subject the employer to administrative penalties.
When do I file the DWC Form-005?
An employer who uses the DWC Form-005 to file a notice of no coverage must file:
• annually between February 1st and April 30th of each calendar year;
• within 30 days of the employer hiring its first employee, unless this due date falls between
February 1st and April 30th and the employer submits the notice within this time period; and
• within 10 days of receipt of a TDI-DWC request for filing a notice of no coverage.
An employer who uses the DWC Form-005 to file a notice of termination of coverage must file:
• within 10 days after notifying the insurance carrier of the termination of coverage unless
the employer purchases a new policy or becomes a certified self-insurer; and
• thereafter, the employer must file the DWC Form-005 as a non-subscriber as long as the
employer remains in operation and does not have workers’ compensation insurance
coverage.
How do I file the DWC Form-005?
Employers can submit the DWC Form-005 to the TDI-DWC by:
• filing electronically on the TDI website at:
https://txcomp.tdi.state.tx.us/TXCOMPWeb/common/home.jsp;
• faxing the form to (512) 804-4146; or
• mailing the form to the address listed at the top of the form (if the filing is for termination of
coverage, the submission must be by certified mail).
How/when must a non-subscriber notify employees that workers’ compensation coverage is not
provided?
An employer must post the Notice to Employees Concerning Workers’ Compensation in Texas in the
workplace in English, Spanish and any other language common to the employer’s employee population
in the print type specified by TDI-DWC rules whenever the employer:
• elects to not have workers’ compensation insurance;
• cancels or terminates workers’ compensation insurance;
• withdraws from certified self-insurance; or
• has its workers’ compensation coverage cancelled by the insurance company.
DWC005 Rev. 01/13 Page 3 of 3
The employer must also provide this notice to each employee:
• at the time of hire;
• when the employer elects to not have workers’ compensation insurance;
• within 15 days of notification to the insurance carrier that the employer is terminating coverage
unless the employer maintains continuous coverage under a new policy or becomes a certified
self-insurer; or
• within 15 days of cancellation by the insurance company.
The required notice may be found on the TDI website at:
http://www.tdi.texas.gov/forms/dwc/notice5.pdf (English) and
http://www.tdi.texas.gov/forms/dwc/notice5s.pdf (Spanish).
Are non-subscribers required to file other forms with the TDI-DWC?
Employers with five or more employees are required to report work-related injuries and diseases to the
TDI-DWC. Non-subscribers and covered employers whose employee(s) have waived workers’
compensation insurance coverage must report these work-related injuries and diseases using the DWC
Form-007, Employer’s Report of Non-covered Employee’s Occupational Injury or Diseases. The form
must be filed not later than the 7th day of the month following the month in which:
• a work-related death occurred,
• an employee was absent from work for more than one day* as a result of an on-the-job injury, or
• the employer acquired knowledge of an occupational disease.
*Do not count the day of the injury or the day the injured employee returned to work when calculating
the number of days absent from work.
The DWC Form-007 can be obtained from the TDI website at:
http://www.tdi.texas.gov/forms/dwc/dwc7.pdf.
Are any fields on the DWC Form-005 optional?
No, all applicable fields must be completed each time the DWC Form-005 is filed.
Additional information can be obtained from the TDI website at:
http://www.tdi.texas.gov/wc/employer/index.html or by calling 1-800-372-7713.
NOTE: With few exceptions, upon your request, you are entitled to be informed about information TDI-DWC
collects about you; receive and review the information (Government Code, §§552.021 and 552.023); and have
TDI-DWC correct information that is incorrect (Government Code, §559.004).
Texas Department of lnsurance
Division of Workers’ Compensation
7551 Metro Center Drive. Suite 100. MS-96
Austin,T X 78744-1645
(8001 372-7713 phons . (5’12) 8044146 tax
Locations of Employer’s Business(es)
Addendum to DWG Form-005 or DWC Form-020
Type or print each item on this form in black ink
Gheck the appropriate box:
|-f AddendumtoDWGForm-005 EmployerNoticeof NoCoverageorTerminationof Coverage
I Addendum to DWC Form-020 lnsurance Carrier Notice of Coverage or Cancellation/Non-renewal
I. PRIMARY EMPLOYER INFORMATION
DWC205
ForT DI-DWCU seO nly
of Coverage
PrimaryE mployer’Bs usinessN ame FederaEl mployelrD Number
II.A DDITIONALB USINESSL OCATIONS
Use this section to add or delete coverage for locations, subsidiaries, and/or separate entities of the primary employer.
Check One: LIADD I_IDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State Zip)
Check One: IIADD IIDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State Zip)
Check One: IJADD IJDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State Zip)
CheckOne: IIADD IfDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State zip)
Check One: LJADD IJDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State Zip)
Check One: IIADD LIDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State Zip)
Gheck One: EADD EDELETE Effective Date
Name Federal Employer lD Number
Address (Street or PO Box, City State Zip)
NOTE: With few exceptions, upon your request, you are entitled to be informed about information TDI-DWC collects about you; receive and review
the information( GovemmentG ode,9 9552.021a nd 552.023)a; nd haveT DI-DWCc orrect informationt hat is incoriect (GovernmenCt ode,5 559.004).
DWC20R5 ev1. 1l10
DWC007
DWC007 Rev. 01/13 Page 1 of 5
Texas Department of Insurance
Division of Workers’ Compensation
7551 Metro Center Drive, Suite 100 • MS-96
Austin, TX 78744-1645
(800) 372-7713 phone • (512) 804-4146 fax
Employer’s Report of Non-covered Employee’s Occupational Injury or Disease
Type or print in black ink
Non-subscribing Employer
Subscribing Employer – Employee Waived Workers’ Compensation Insurance Coverage
I. EMPLOYER INFORMATION
1. Employer Business Name
2. Reporting Period (mm/yyyy) 3. Number of Injured Employees Included on This Report
4. Employer Business Mailing Address
(Street or PO Box, City, County, State, Zip Code)
5. Provide the following:
NAICS
Codes
NAICS
Employment
6. Employer Physical Address (Street, City, State, Zip Code)
7. Employer Phone Number
8. Federal Employer ID Number
9. Name of Person Completing Form
10. Phone Number of Person Completing Form
11. Title of Person Completing Form
12. Signature of Person Completing Form 13. Date of Signature (mm/dd/yyyy)
II. INJURED EMPLOYEE INFORMATION / INJURY DATA
14. Employee Name (First, Middle, Last) 15. Employee’s SSN
16. Date of Birth (mm/dd/yyyy) 17. Date of Hire (mm/dd/yyyy) 18. Sex
Male Female
19. Occupation 20. Hourly Wage 21. Employee NAICS Code
22. Race/Ethnic Identification
White Black Hispanic Asian or Pacific Islander American Indian or Alaskan Native
Other (specify)
For TDI-DWC Use Only
DWC007
DWC007 Rev. 01/13 Page 2 of 5
23. Address Where Injury/Occupational Disease Occurred (Street, City, State, Zip Code)
24. Type of Location Where Injury/Occupational Disease Occurred
Primary Business Location On-site Job Location Traveling between Job Locations
25. Date of Injury/Occupational Disease (mm/dd/yyyy) 26. Date Reported By Employee (mm/dd/yyyy)
27. Return to Work Date or Expected Date (mm/dd/yyyy)
28. Reported Cause of Injury
29. Nature of Injury/Occupational Disease
30. Equipment Involved in the Injury (if any)
31. Body Part(s) Affected
32. First Day of Absence from Work (mm/dd/yyyy) 33. Number of Days Absent from Work
1 Day or Less >1 Day – 7 Days 8 Days or More
34. Occupational Disease
Yes No
35. Fatality Yes No
If Yes, provide date (mm/dd/yyyy)
36. Description of Incident
NOTE1: Title 28 Texas Administrative Code, Chapter 160 requires employers to report work-related deaths, on-the-job
injuries and occupational diseases in the form and manner required by TDI-DWC. The social security number may be used
to identify the injured employee.
NOTE2: With few exceptions, upon your request, you are entitled to be informed about information TDI-DWC collects about
you; receive and review the information (Government Code, §§552.021 and 552.023); and have TDI-DWC correct information
that is incorrect (Government Code, §559.004)
Employer’s Name:
Employer’s FEIN:
For TDI-DWC Use Only
DWC007
DWC007 Rev. 01/13 Page 3 of 5
Injury Data for Additional Injured Employee(s)
(reproduce this page, if necessary)
Employer Business Name
Employer FEIN Reporting Period (mm/yyyy)
II. INJURED EMPLOYEE INFORMATION / INJURY DATA
14. Employee Name (First, Middle, Last) 15. Employee’s SSN
16. Date of Birth (mm/dd/yyyy) 17. Date of Hire (mm/dd/yyyy) 18. Sex
Male Female
19. Occupation 20. Hourly Wage 21. Employee NAICS Code
22. Race/Ethnic Identification
White Black Hispanic Asian or Pacific Islander American Indian or Alaskan Native
Other (specify)
23. Address Where Injury/Occupational Disease Occurred (Street, City, State, Zip Code)
24. Type of Location Where Injury/Occupational Disease Occurred
Primary Business Location On-site Job Location Traveling between Job Locations
25. Date of Injury/Occupational Disease (mm/dd/yyyy) 26. Date Reported By Employee (mm/dd/yyyy)
27. Return to Work Date or Expected Date (mm/dd/yyyy)
28. Reported Cause of Injury
29. Nature of Injury/Occupational Disease
30. Equipment Involved in the Injury (if any)
31. Body Part(s) Affected
32. First Day of Absence from Work (mm/dd/yyyy) 33. Number of Days Absent from Work
1 Day or Less >1 Day – 7 Days 8 Days or More
34. Occupational Disease
Yes No
35. Fatality Yes No
If Yes, provide date (mm/dd/yyyy)
36. Description of Incident
For TDI-DWC Use Only
DWC007
DWC007 Rev. 01/13 Page 4 of 5
Frequently Asked Questions
Employer’s Report of Non-covered Employee’s Occupational Injury or Disease (DWC Form-007)
Which employers are required to report on-the-job injuries, occupational diseases, and workrelated
deaths on the DWC Form-007?
The following employers are required to file the DWC Form-007:
• An employer that does not have workers’ compensation insurance coverage (non-subscriber)
and employs five or more employees who are not exempt from workers’ compensation
insurance coverage must file the DWC Form-007 to report all on-the-job injuries and occupational
diseases. Examples of exempt employees include certain domestic workers, and certain farm and
ranch workers.
• An employer that has workers’ compensation insurance coverage must file the DWC Form-007 to
report an on-the-job injury or occupational disease for an employee who has waived workers’
compensation insurance coverage in accordance with Texas Labor Code §406.034.
Failure to file the form may subject the employer to administrative penalties.
What do I do if I need to report more than two injured employees?
Copy page three of the form as many times as necessary for reporting additional injured employees.
When do I file the DWC Form-007?
The form must be filed not later than the 7th day of the month following the month in which:
• a work-related death occurred,
• an employee was absent from work for more than one day* as a result of an on-the-job injury; or
• the employer acquired knowledge of an occupational disease.
*Do not count the day of the injury or the day the injured employee returned to work when calculating the
number of days absent from work.
NOTE: If no such deaths, injuries, or diseases occurred during a calendar month, no report is required
for that month.
Are any fields on the DWC Form-007 optional?
No, all applicable fields must be completed each time the DWC Form-007 is filed.
How do I file the DWC Form-007?
Submit the DWC Form-007 to the Texas Department of Insurance, Division of Workers’ Compensation
(TDI-DWC) by:
• faxing the form to (512) 804-4146; or
• mailing the form to the address listed at the top of the form.
DWC007
DWC007 Rev. 01/13 Page 5 of 5
Instructions for Completing Specific Items
Box 5: Employer NAICS Codes*/Employment
List all six-digit NAICS Codes which the employer uses with the FEIN specified in Box 8. Provide the
highest employment figure for each NAICS Code for the month of the report. Employment means all
employees on your payroll whether full-time, part-time, temporary, or permanent. Attach additional
pages, if necessary.
Box 21: Employee NAICS Code*
List the six-digit NAICS Code of the activity that the employee was engaged in at the time of the injury or
disease. The code listed must be one of the six-digit NAICS Code numbers reported in Box 5.
Box 22: Race/Ethnic Identification
Check appropriate box and provide requested information, if applicable. Information as to the
race/ethnicity of the employee will be maintained for non-discriminatory statistical use.
NOTE: Hispanic, while not a race identification, is included as a separate race/ethnic category. Do not
include Hispanic under “white” or “black”.
Box 28: Reported Cause of Injury
Enter the most probable cause of the injury or disease. Examples: overexertion due to lifting or pushing,
caught between, slip, trip, fall.
Box 29: Nature of Injury/Occupational Disease
Enter the type of injury or occupational disease. Examples: cut, burn, bruise, fracture, sprain, strain,
chemical burn, dermatitis, asbestosis, silicosis. For multiple injuries, use most serious.
Box 33: Number of Days Absent from Work
• Occupational disease: Must be reported regardless of the number of days the employee is absent
from work. Check the appropriate box, including 1 Day or Less.
• On-the-job injury: Must be reported only if the employee is absent from work for more than one
day. Do not check 1 Day or Less.
Box 36: Description of Incident
Provide a short narrative of how the incident occurred. Example: While painting house, fell off ladder and
fractured arm.
*Information on NAICS Codes can be found on the United States Census Bureau website at
www.census.gov/eos/www/naics. NAICS Codes can also be obtained from the North American Industry
Classification System published by the National Technical Information Service, 5285 Port Royal Road,
Springfield, Virginia 22161; e-mail: info@ntis.fedworld.gov.
Notice to New Employees Rev. 01/13 DIVISION OF WORKERS’ COMPENSATION
Texas Department of Insurance
Division of Workers’ Compensation
7551 Metro Center Drive, Suite 100 • Austin, Texas 78744-1645
512-804-4000 telephone • 512-804-4001 fax • www.tdi.texas.gov
YOU MAY USE YOUR OWN LETTERHEAD WITH
THE FOLLOWING INFORMATION
Reference Rule 110.101
(a) In addition to the posted notice required by subsection (e) of this section, employers, as
defined by Labor Code Section 406.001, shall notify their employees of workers’
compensation insurance coverage status, in writing. This additional notice:
(1) shall be provided at the time an employee is hired, meaning when the employee is
required by federal law to complete both a W-4 form and an I-9 form or when a
break in service has occurred and the employee is required by federal law to
complete a W-4 form on the first day the employee reports back to duty;
(2) shall be provided to each employee, by an employer whose workers’
compensation insurance coverage is terminated or cancelled, not later than the 15th
day after the date on which the termination or cancellation of coverage takes
effect;
(3) shall be provided to each employee, by an employer who obtains workers’
compensation insurance coverage, not later than the 15th day after the date on
which coverage takes effect, as necessary to allow the employee to elect to retain
common law rights under Labor Code Chapter 406;
(4) shall include the text required in the posted notice (see rule 110.101 (e)(1), (e)(2),
(e)(3), (e)(4) for appropriate language); and
(5) if the employer is covered by workers’ compensation insurance (subscriber) or
becomes covered, whether by commercial insurance or through self-insurance as
provided by the Texas Workers’ Compensation Act (Act), shall include the
following statement:
NOTICE TO NEW EMPLOYEES
“You may elect to retain your common law right of action if, no later than five days
after you begin employment or within five days after receiving written notice from
the employer that the employer has obtained workers’ compensation insurance
coverage, you notify your employer in writing that you wish to retain your common
law right to recover damages for personal injury. If you elect to retain your
common law right of action, you cannot obtain workers’ compensation income or
medical benefits if you are injured.”
NOTICE TO EMPLOYEES CONCERNING
WORKERS’ COMPENSATION IN TEXAS
COVERAGE: [Name of employer] does not
have workers’ compensation insurance coverage. As an employee of a non-covered employer, you
are not eligible to receive workers’ compensation benefits under the Texas Workers’ Compensation
Act. However, a non-covered (non-subscribing) employer can and may provide other benefits to
injured employees. You should contact your employer regarding the availability of other benefits for
a work-related injury or occupational disease. In addition, you may have rights under the common
law of Texas should you have an on the job injury or occupational disease. Your employer is required
to provide you with coverage information, in writing, when you are hired or whenever the employer
becomes, or ceases to be, covered by workers’ compensation insurance.
SAFETY VIOLATIONS HOTLINE: The Division has a 24 hour toll-free telephone number
for reporting unsafe conditions in the workplace that may violate occupational health and safety
laws. Employers are prohibited by law from suspending, terminating, or discriminating against any
employee because he or she in good faith reports an alleged occupational health or safety violation.
Contact the Division at 1-800-452-9595.
Notice 5 (01/13) TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS’ COMPENSATION Rule 110.101(e)(4)
Non-Covered Employer
Texas Workers’ Compensation Rule 110.101(e)(4) requires employers who are not covered by
workers’ compensation, either by election, cancelation or termination of coverage to advise their
employees that they do not have workers’ compensation insurance coverage.
Notices in English, Spanish and any other language common to the employer’s employee population
must be posted and:
1. Prominently displayed in the employer’s personnel office, if any;
2. Located about the workplace in such a way that each employee is likely to see the notice on a
regular basis;
3. Printed with a title in at least 26 point bold type, subject in at least 18 point bold type, and text in
at least 16 point normal type; and
4. Contain the exact words as prescribed in Rule 110.101(e)(4).
The notice on the reverse side meets the above requirements. Failure to post or to provide notice
as required in the rule is a violation of the Act and Division rules. The violator may be subject to
administrative penalties.
Do Not Post This Side
COBERTURA: [Name of employer]
no cuenta con una cobertura de seguro
de compensación para trabajadores. Como empleado de un empleador que
no cuenta con una cobertura, usted no es elegible para recibir beneficios
de compensación para trabajadores bajo la Ley de Compensación para
Trabajadores de Texas. Sin embargo, un empleador no cubierto (no
suscriptor) puede y debe proporcionar otros beneficios a los empleados
lesionados. Usted debe comunicarse con su empleador para obtener
información sobre la disponibilidad de otros beneficios por una lesión o
enfermedad ocupacional relacionada con el trabajo. Además, usted podría
tener derechos bajo la ley de “Derecho Común de Texas” (Common Law of
Texas, por su nombre en inglés), en caso de que usted llegara a sufrir una
lesión o enfermedad ocupacional relacionada con el trabajo. Su empleador
tiene la obligación de proporcionarle a usted información por escrito sobre
la cobertura cuando usted es contratado o cuando su empleador adquiere o
deja de tener una cobertura de seguro de compensación para trabajadores.
LÍNEA DIRECTA PARA REPORTAR VIOLACIONES DE
SEGURIDAD: La División cuenta con una línea gratuita telefónica que
está en servicio las 24 horas del día para reportar condiciones inseguras
en el área de trabajo que podrían violar las leyes ocupacionales de salud
y seguridad. La ley prohíbe que los empleadores suspendan, despidan o
discriminen en contra de cualquier empleado porque él o ella de buena
fe reporta una alegada violación ocupacional de salud o seguridad.
Comuníquese con la División al teléfono 1-800-452-9595.
AVISO A LOS EMPLEADOS SOBRE
LA COMPENSACIÓN PARA
TRABAJADORES EN TEXAS
Notice 5 (01/13) TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS’ COMPENSATION Rule 110.101(e)(4)
EMPLEADORES SIN COBERTURA
El Reglamento 110.101 (e)(4) de Compensación para Trabajadores de
Texas requiere que los empleadores que no cuentan con una cobertura
de compensación para trabajadores, ya sea por elección, cancelación o
anulación de la cobertura notifiquen a sus empleados que no cuentan con
una cobertura de seguro de compensación para trabajadores.
Avisos en inglés, español y cualquier otro idioma común para la población
de los trabajadores del empleador deben ser puestos a la vista y:
1. Mostrarse en un lugar prominente de la oficina de personal del
empleador, si es que la hay;
2. Ubicar este aviso en el área de trabajo de tal manera que los
empleados lo vean regularmente;
3. El título debe ser impreso en tamaño 26, en letra negrita de punto, el
tema debe ser impreso en tamaño 18, en letra negrita de punto, y el
texto, por lo menos en tamaño 16 en letra negrita de punto normal; y
4. Contener las palabras exactas según lo señalado en el Reglamento
110.101 (e)(4).
El aviso que se muestra al reverso de esta página cumple con los
requisitos que se han señalado en la parte de arriba. El negarse a mostrar
o proporcionar esta información, según lo requerido en el reglamento es
una falta a la ley y a los reglamentos de la División. El infractor podría estar
sujeto a sanciones administrativas.
NO MOSTRAR ESTE LADO
Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.