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Workers' compensation form 13l 50

Workers exemption 2026

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4.8 out of 5

245 votes

The document outlines the process for obtaining an exemption from workers' compensation insurance for contractors in California. It specifies that applicants must certify they do not employ anyone subject to California's workers' compensation laws and provides instructions on completing the exemption form. Certain conditions, such as having an inactive license or holding a C-39 Roofing classification, disqualify applicants from seeking this exemption. The document also emphasizes the importance of providing accurate information and the consequences of falsification.

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Click ‘Get Form’ to open the workers exemption form in the editor.
In Section 1, enter your business name as it appears on CSLB records, along with your license or application fee number. Fill in your business mailing address, including city, state, and zip code. Ensure you also provide your business street address and contact details.
In Section 2, carefully check only one of the boxes provided. Choose whether you do not employ anyone subject to California's workers' compensation laws or if you are an out-of-state contractor without California employees.
Proceed to Section 3. Here, certify under penalty of perjury that the information is accurate by signing and dating the form. Ensure that your printed name is included as well.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (245 Votes)
2011	4.4 Satisfied (138 Votes)
2008	4.3 Satisfied (126 Votes)

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