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Self employment affidavit form

Self employed affidavit 2026

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4.4 out of 5

71 votes

The document is an affidavit for self-employment exemption under the Workers' Compensation Act, stating that the individual is applying for a contractor's license in Arizona and confirms they are self-employed without regular employees. It outlines their understanding of compliance with the Workers' Compensation Act and the conditions under which they may use independent contractors.

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Click ‘Get Form’ to open the self employed affidavit in the editor.
Begin by entering your printed name in the designated field at the top of the form.
In section 1, clearly state that you are applying for a contractor’s license through the appropriate state office.
Proceed to sections 2 through 9, where you will affirm your understanding of compliance with the Workers' Compensation Act. Ensure each statement accurately reflects your employment status and intentions regarding hiring workers.
In section 10, confirm your authority to sign on behalf of your company by entering your title and signing in the provided space.
Finally, ensure that a notary public completes their section at the bottom of the form, including their signature and commission expiration date.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (63 Votes)
2014	4.4 Satisfied (71 Votes)

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