Libc 513 2026

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The document outlines the process for executive officers of corporations in Pennsylvania to declare their exemption from being classified as employees under the Pennsylvania Workers' Compensation Act. It includes instructions for completing the Executive Officer's Declaration form, which must be submitted with the Application for Executive Officer Exception, and specifies that the total ownership interest declared must equal 100%. The document also provides guidelines for filling out the form correctly to ensure it is accepted by the Bureau of Workers' Compensation.

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Click ‘Get Form’ to open libc 513 in the editor.
Begin by entering the Corporation’s Full Legal Name in the designated field. Ensure accuracy as this is crucial for processing.
Fill in the Executive Officer’s details: First Name, Middle Name, Last Name, and Suffix. Use uppercase letters for clarity.
Indicate your ownership interest by checking only one box that applies to your situation: Subchapter S corporation, Subchapter C corporation, or nonprofit corporation.
Complete the Percentage of Ownership field accurately, ensuring it reflects your actual stake in the corporation.
Provide your Social Security Number and contact information including Telephone and Address. Remember to format numbers correctly without parentheses.
Finally, sign and date the form at the bottom. Ensure all information is true to avoid penalties under Pennsylvania law.

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What is the most common workers compensation claim?

Exemptions include: people covered under other workers compensation acts, such as railroad workers, longshoremen and federal employees; domestic servants (coverage is optional); agricultural workers who work fewer than 30 days or earn less than $1,200 in a calendar year from one employer; and employees who have

What is the libc form?

0:15 1:42 Form what do I do with it. This is a form thats sent by the insurance. Companies if youreMoreForm what do I do with it. This is a form thats sent by the insurance. Companies if youre collecting workers compensation or if youre attempting to collect workers compensation.

What is libc 362?

The first step in appealing a denied claim is to file a Claim Petition with the Pennsylvania Bureau of Workers Compensation within three years from the date of injury. The claimant (the person whose claim is denied) can file a Claim Petition (LIBC-362) on the Pennsylvania Department of Labor and Industry website.