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Workman s Compensation Waiver 2026
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- Click ‘Get Form’ to open it in the editor.
- In the first field, enter your name as the owner/operator of the company. Make sure to print it clearly.
- Next, fill in your company name in the designated field. This identifies the business for which you are requesting a waiver.
- Review the statement regarding workers' compensation coverage requirements carefully before signing.
- Sign and date the form in the provided sections to confirm your request for exemption.
- Finally, ensure that a Notary Public witnesses your signature and completes their section of the form.
Start filling out your Workman’s Compensation Waiver form online for free today!
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2014 | 4.8 Satisfied (130 Votes) |
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Related links
The following entity categories may be eligible for the waiver: Sole Proprietorships with no employee other than the owner. Partnerships with no employeesRead more
I,. , hereby request that The Pennsylvania State University waive the requirement that I carry Workers Compensation and Employers Liability insurance in orderRead more