1. (a) The form required to be posted by G.S. 97-93(e) is the Form 17 Workers' Compensation Notice to Injured Workers and Employers, that includes the following:

   1. (1) name of insurer;
   2. (2) policy number; and
   3. (3) dates of coverage.
2. (b) If there is a change in coverage, the Form 17 Workers' Compensation Notice to Injured Workers and Employers shall be amended within five working days.

History Note: Authority G.S. 97-80(a); 97-93;
Eff. January 1, 1990;
Amended Eff. November 1, 2014; March 15, 1995;
Recodified from 04 NCAC 10A .0201 Eff. June 1, 2018.