Dwc form 83 2026

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The document outlines an agreement between a Hiring Contractor and an Independent Contractor under the Texas Workers' Compensation Act. It defines the criteria for an Independent Contractor, establishes their relationship, and clarifies that the Hiring Contractor will not withhold workers' compensation insurance costs from the Independent Contractor's payment. The agreement specifies that it only applies for workers' compensation purposes and must be filed with the Texas Department of Insurance.

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Click ‘Get Form’ to open the dwc form 83 in the editor.
Begin by filling in the 'Hiring Contractor' section. Enter the name, address, and Federal Tax I.D. Number of the Hiring Contractor.
Next, complete the 'Independent Contractor' section. Provide the name, address, and Federal Tax I.D. Number of the Independent Contractor.
In the 'Term (Dates) of Agreement' section, specify the start and end dates for this agreement.
Indicate the estimated number of employees affected by this agreement in the designated field.
Fill out the location of each affected job site or state if this is a blanket agreement.
Both parties must sign and date the form at their respective signature fields to finalize the agreement.

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dwc form 83

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