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Massachusetts form 153

Ma form 153 exemption 2026

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Form 153 is an affidavit for corporate officers or directors in Massachusetts who own at least 25% of a corporation's stock, allowing them to waive their rights under the state's workers' compensation laws (M.G.L. c. 152). The form outlines the conditions under which these officers can be exempt from carrying workers' compensation insurance and details the obligations of the corporation regarding employee coverage. It must be signed by all eligible officers and submitted to the Department of Industrial Accidents.

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Click ‘Get Form’ to open the ma form 153 exemption in the editor.
Begin by filling in the 'Invest./SWO ID #' field at the top of the form, if applicable.
In the section labeled 'Name of Corporation and Address', enter the full name and address of your corporation.
Each corporate officer must sign under their respective names, indicating whether they wish to exercise their right of exemption by checking the appropriate box.
Ensure that all eligible corporate officers have signed. Remember, there can be no more than four signatures on this form.
Finally, review all entries for accuracy before submitting the completed form to the Department of Industrial Accidents.

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Versions	Form popularity	Fillable & printable
2010	4.9 Satisfied (459 Votes)
2002	4 Satisfied (22 Votes)

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