Fill out tl form 2026

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The document is a Workers' Compensation Declaration Form from the Public Utilities Commission of California, requiring businesses to declare their employee status for compliance with California's workers' compensation laws. It outlines the obligations for out-of-state corporations and mandates the submission of a certificate of workers' compensation insurance or consent to self-insure if applicable. The form includes options for declaring whether the business currently has employees and requires certification under penalty of perjury.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your file number in the designated space at the top of the form. This is crucial for tracking your submission.
Indicate whether you have employees residing in California by checking either box A or B. If you select box A, remember to attach a written explanation regarding your operations without employees.
If you check box B, ensure that you contact your insurance company to obtain the required certificate of coverage and have it mailed to the Commission.
Complete the certification section by signing and dating the form. Ensure all signatures are from authorized individuals, including a corporate officer if applicable.

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