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AFFIDAVIT OF EXEMPT STATUS UNDER THE WORKERS COMPENSATION CODE 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling in your name and the county where you are submitting the affidavit. This establishes your identity and jurisdiction.
- In the first section, provide a detailed statement under oath regarding your status as an independent contractor. List any relevant points that support your exempt status.
- Complete the section where you identify the contractor you will be working with, including their name and the calendar year for which this affidavit applies.
- Review and check off statements in the Exempt Status Fact Sheet that apply to your situation. Ensure at least six statements are checked to confirm your independent contractor status.
- Sign and date the affidavit, ensuring that all information is accurate and truthful to avoid penalties for false information.
- Finally, have the document notarized before submitting it to your general contractor as instructed.
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