| Section Name | Field Name | Field and/or Section Description |
| The title of the form. ACORD 135 NC, North Carolina Workers Compensation Insurance | ||
| North Carolina Workers | Plan, Application for Designation of an Insurance Company, is the application for workers | |
| CompensationInsurance Plan, | compensation insurance coverage required by the North Carolina Workers Compensation | |
| TITLE | Application for Designation of an | Insurance Plan. See ACORD 136 NC for instructions on the completion of this |
| ACORD 135 NC (2009/08) | Insurance Company | application. |