Texas form84 2026

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The document is a notice from the Texas Department of Insurance, Division of Workers' Compensation, declaring an exception to the Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers. It outlines that this agreement does not apply to a specific hiring agreement between a Hiring Contractor and an Independent Contractor. The document includes sections for affirmations, signatures, and necessary details regarding the contractors involved, as well as instructions for filing with the workers' compensation insurance carrier.

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Click ‘Get Form’ to open Texas Form 84 in the editor.
Begin by entering the 'Date of Joint Agreement' and 'Date of Subsequent Hiring Agreement' at the top of the form. Ensure these dates are accurate as they are crucial for record-keeping.
Fill in the 'Location of Specific Job Sites Not Affected by Joint Agreement' section. This helps clarify which job sites are exempt from the joint agreement.
Next, provide details for both the Hiring Contractor and Independent Contractor. Include names, addresses, and Federal Tax I.D. Numbers to ensure proper identification.
Both parties must sign and date the form in their respective sections. This step is essential for validating the agreement.
Finally, review all entries for accuracy before saving your completed form. Retain a copy for your records and submit it to the appropriate workers’ compensation insurance carrier within 10 days.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (51 Votes)
2018	4.3 Satisfied (80 Votes)
2005	4.3 Satisfied (49 Votes)

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Texas form84 2026

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