Notice Of Revocation Of Election To Be Exempt Page 2

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WORKERS’ COMPENSATION COMPLIANCE FIELD OFFICES
400 West Robinson Street
2295 Victoria Avenue, Suite 284
Room #512, North Tower
Ft. Myers, FL 33901
Orlando FL 32801-1756
Telephone (239) 461-4006
Telephone (407) 835-4406
nd
401 NW 2
Avenue
610 E. Burgess Road
Suite #318, South Tower
Pensacola, FL 32504-6320
Miami FL 33128-1740
Telephone (850) 453-7804
Telephone (305) 536-0306
3111 S. Dixie Highway, Suite # 123
TALLAHASSEE SUBMITTERS
West Palm Beach FL 33405
Walk-in submissions:
Telephone (561) 837-5716
2012 Capital Circle SE
Suite #102, Hartman Bldg.
1313 N. Tampa Street, Suite # 503
Tallahassee FL 32399-2161
Tampa FL 33602
Telephone (850) 413-1609
Telephone (813) 221-6506
Mail in submissions:
921 North Davis Street
200 East Gaines Street
Building B, Suite #250
Tallahassee FL 32399-4228
Jacksonville, FL 32209
Telephone (850) 413-1609
Telephone (904) 798-5806
DFS-F2-DWC-250-R, NOTICE OF REVOCATION OF ELECTION TO BE EXEMPT - REVISED 08-13

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