Dwc form 83 2026

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The document outlines the process for establishing an independent contractor relationship under the Texas Workers' Compensation Act. It includes a declaration that confirms the independent contractor's status, stipulating that they and their employees are not entitled to workers' compensation coverage from the hiring contractor. Additionally, it provides an option for the hiring contractor to agree to provide workers' compensation insurance coverage for the independent contractor and their employees, defining the employer-employee relationship solely for this purpose. The agreement must be filed with the Texas Department of Insurance and retained by both parties.

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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 with their name, address, and Federal Tax I.D. Number.
Indicate whether the Hiring Contractor will withhold costs for workers' compensation insurance by checking the appropriate box.
Fill in the 'Term (Dates) of Agreement' section by specifying the start and end dates of this agreement.
Provide details about each affected job site or state if this is a blanket agreement in the designated area.
Estimate and enter the number of employees affected by this agreement.
Both parties must sign and date the form at their respective sections to finalize it.

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