Termination of insurance agreement

Termination of insurance agreement
Non-Swedish companies with temporary operations in Sweden
Fora AB, SE-101 56 Stockholm, Sweden
Agreement no.
Telephone: + 46 8 787 40 10
Visitor address: Vasagatan 12
CIN: 556541-8356
Fill in name and adress below
Please send the form to:
Fora AB, SE-101 56 Stockholm
or fax to +46 8 787 40 90
The insurance agreement may not be terminated as long as there are employees still covered by collective agreements.
We recommend that you maintain insurance coverage even if the company operates without employees, since self-employed
persons and their spouses/registered partners who are active in the business are covered by Work Injury Insurance (TFA).
If you have taken out ”Insurance for the self-employed” and want this to remain valid, your agreement for collective employee
insurance must also remain in force.
In the event that there are no employees, the agreement for collective employee insurance currently costs SEK 450 per
calendar year.
The undersigned employer hereby terminates the insurance agreement for collective insurance
Operations in Sweden have ceased
No employees
End date of last employment
Other reason
State reason and date for termination of
the insurance agreement
Other information
AP06 1308
Name (printed)
Authorised signatory
E-mail address
Telephone no. (with country and
area code.)