Termination of Nonelection of Workers' Compensation or Employers' Liability Coverage

Official State of Iowa Website Here is how you know

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Export format

Microsoft Excel

Delimited text

Warning: Opening delimited text files with spreadsheet applications may expose you to formula injection or other security vulnerabilities. When the submissions contain data from untrusted users and the downloaded file will be used with spreadsheets, use Microsoft Excel format.

Delimited text format

This is the delimiter used in the CSV/TSV file when downloading Webform results. Using tabs in the export is the most reliable method for preserving non-latin characters. You may want to change this to another character depending on the program with which you anticipate importing results.

Column header format

None

Label

Form Key

Select list options

Select keys

Full, human-readable options (values)

Short, raw options (keys)

Select list format

Separate

Option A	Option B	Option C
X
X		X
	X	X

Separate options are more suitable for building reports, graphs, and statistics in a spreadsheet application.

Compact

My select list
Option A
Option A,Option C
Option B,Option C

Compact options are more suitable for importing data into other systems.

Included export components

Include all components
Submission information
Serial
SID
Submitted Time
Completed Time
Modified Time
Draft
IP Address
UID
Username
Information About Employer
Name of Employer:
Type of Entity:
Address of Employer's Home Office:
Agreements by Individual.
Statement 1 Agreement:
Statement 2 Agreement:
Statement 3 Agreement:
Statement 4 Agreement:
Individual Information
Date:
Full Name of Individual:
Email:
City of Residence:
County of Residence:
State of Residence:
Full Name of Witness 1:
Full Name of Witness 2:
Signed Indication:
Signed Agreement form 4:
Termination by Employer.
Termination Agreement:
Employer Information
Full Name of Authorized Agent:
Email of Authorized Agent:
Relationship to Employer of Authorized Agent:
City of Residence:
County of Residence:
State of Residence:
Full Name of Witness No. 1:
Full Name of Witness No. 2:
Signed indication:
Form 4 Lower Signed Agreement:

Download range options

All submissions (8 total)

Only new submissions since your last download (7 new since 2020-01-29)

Only the latest submissions

Submissions by number from and optionally to: (Last downloaded: 7)

Submissions by date from and optionally to:

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