State of Rhode Island, Department of Labor and Training
Division of Workers’ Compensation
P.O. Box 20190, Cranston, RI 02920-0942
Phone (401) 462-8100 TDD (401) 462-8084 www.dlt.ri.gov
Designation of Agent for Service of Process Pursuant to § 28-29-9
R
esident Agent for Service of Process:
Employer Signature:
Date:
§ 28-29-9
Service of process on nonresident employers.
Every employer, subject to or who elects to become subject to the provisions of chapters 29 38 of this title, other than a
corporation, who is not a resident of the state or an unincorporated association, a firm or a partnership, having no members
resident of the state, shall file with the director a duly executed written power appointing some competent person resident in
this state as the employer's agent with authority to accept service of process against the employer in this state and upon
whom all process, including the process of garnishment, against the employer in this state may be served, and who, in case
of garnishment when the fees for it have been paid or tendered, shall make the affidavit required by law in those cases, and
who shall cause an appearance to be entered in like manner as if the employer had resided and been duly served with
process within this state. Service of process upon the resident agent shall be deemed sufficient service upon the employer.
If the resident agent dies, resigns, or moves from the state, the employer shall file with the director a further written power
appointing some other competent person residing in this state as agent for service of process purposes. No power of
agency shall be revoked until after a like power has been given to some other competent person resident in this state and
filed as provided. Any nonresident employer who has duly filed a withdrawal of election to be subject to the provisions of
chapters 29 38 of this title may revoke his or her power of agency by a written instrument of revocation filed with the
director. No revocation shall be effective as to any liability arising out of any act or omission on the part of the employer
occurring prior to the time when the withdrawal of acceptance of the provisions of those chapters became effective.
Employer:
Address:
Address:
City/St/Zip:
E-mail:
Telephone:
Agent:
Address:
Address:
City/St/Zip:
Telephone: