Workers Comp - Form 61 A 2026

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The document is a Contractor's Certificate of Workers' Compensation Insurance (Form 61A) that requires contractors to provide their business information, insurance details, and compliance with Virginia's workers' compensation laws. It outlines the necessary steps for completing the form, including providing the contractor's name, address, Federal Employer ID, and insurance carrier information. Additionally, it includes questions regarding employee count and subcontractor usage to determine insurance requirements. The form must be returned to the local Commissioner of the Revenue.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Contractor's Business or Trade Name, followed by the Last and First Name of the Contractor. Ensure all information is legible.
Input the Contractor's Federal Employer ID (FEIN) or Tax ID Number. If you do not have one, consider obtaining a Temporary FEIN from the Virginia Tax Department.
Fill in the Contractor's Business Address if it differs from the Mailing Address, along with the City, State, and Zip code.
Provide your Home Telephone number and complete the Workers’ Compensation Insurance section. Indicate your insurance type and fill in details such as Insurance Carrier name and Policy Number.
If you do not have workers' compensation insurance, answer the additional questions regarding employee count and subcontractors.
Finally, sign and date the form at the bottom to certify that all information is accurate before submitting it to your local Commissioner of Revenue.

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Versions	Form popularity	Fillable & printable
2024	4.8 Satisfied (58 Votes)
2014	4.8 Satisfied (40 Votes)
2014	4.8 Satisfied (80 Votes)
2013	4 Satisfied (32 Votes)
2012	4 Satisfied (21 Votes)
2012	4 Satisfied (42 Votes)
2010	4.5 Satisfied (78 Votes)

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How much does it cost to apply for workers comp exemption in Florida?

with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability member are allowed to be exempt. A $50 fee is required for each application submitted to obtain an exemption.

How long does it take to get a Florida workers comp exemption?

How long does it take to get a workers compensation exemption in Florida? Print a workers comp exemption form or fill it out online, and wait for 3 to 5 business days for processing with the Florida Division of Workers Compensation.

Who needs a workers comp exemption?

Only a few worker categories are sometimes exempt, such as agricultural workers and real estate agents. This exemption can also apply to certain types of business owners sole proprietors, independent contractors, and members of limited liability companies (LLCs).

What is the difference between Form 61 and 61A?

These forms help maintain transparency: Form 61: Records transactions by those without a PAN. Form 61A: Tracks large transactions.

How do I apply for workers comp exemption in Florida?

In order to apply for or renew an exemption from workers compensation law, the exemption applicant must complete and submit a Notice of Election to be Exempt application online to the Florida Division of Workers Compensation.

form 61a

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What is proof of coverage in Virginia workers comp?

Proof of coverage shall include the name and address of the insured, the insureds federal employer identification number (FEIN), the policy number, dates of insurance coverage, the name and address of the insurer, and the insurers identification number.

What is the most common workers compensation claim?

Common Causes of Workers Compensation Claims Strains and Sprains. Strains and sprains are by far the most common on-the-job injury for workers. Cuts and Punctures. Severe Cuts and Lacerations. Overuse or Repetitive Stress Injuries, Including Back Injuries. Fractures.

Workers Comp - Form 61 A 2026

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How to use or fill out Workers Comp - Form 61 A with DocHub

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How much does it cost to apply for workers comp exemption in Florida?

How long does it take to get a Florida workers comp exemption?

Who needs a workers comp exemption?

What is the difference between Form 61 and 61A?

How do I apply for workers comp exemption in Florida?

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What is proof of coverage in Virginia workers comp?

What is the most common workers compensation claim?

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