AFFIDAVIT OF EXEMPTION FOR WORKERS COMPENSATION INSURANCE 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the designated field for the Affiant. Ensure that you are of legal age and sound mind, as this is a sworn statement.
3. Next, provide the name of your business in the specified section. This should reflect your role as a sole proprietor, owner, or partner.
4. Indicate your exemption reason by checking one of the provided options: either you have no employees, are a partner with no employees, or have filed a Notice of Employer’s Exemption.
5. If applicable, attach a copy of the Notice of Employer’s Exemption and ensure you include the date when this was filed.
6. Confirm that you have not filed a notice to withdraw your exemption and understand the legal implications of providing false information.
7. Finally, sign and date the affidavit before a notary public to complete the process.

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