AFFIDAVIT OF EXEMPT STATUS UNDER THE WORKERS COMPENSATION CODE 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your name and the county where you are submitting the affidavit. This establishes your identity and jurisdiction.
  3. 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.
  4. 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.
  5. 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.
  6. Sign and date the affidavit, ensuring that all information is accurate and truthful to avoid penalties for false information.
  7. Finally, have the document notarized before submitting it to your general contractor as instructed.

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New Jersey workers compensation law exempts unpaid interns, unpaid volunteers, independent contractors and sole proprietors with no employees from its workers comp law.
In California, independent contractors are generally not eligible for workers compensation coverage. These individuals are considered to be self-employed, and they typically negotiate their terms and conditions of employment. Independent contractors assume responsibility for their own insurance and tax liabilities.
The South Dakota Affidavit of Exempt Status, when signed, creates a presumption that an individual independent contractor is not an employee for the purposes of the states Workers Compensation Act.
Independent contractors, sole proprietors, business partners, or LLC members in a firm with no employees dont typically need workers compensation. However, clients may request a copy of your workers comp certificate of insurance (COI) before continuing any work with you.
If you are a sole proprietor with no employees, you are not required to carry workers compensation coverage on yourself. There is no need to sign a waiver or take any action if your business is in this category. The single exception is roofers, who are required to carry coverage even if they dont have employees.
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People also ask

All employees in Hawaii must be covered by workers compensation unless they legally opt out of coverage or are on the list of exempt employment types. Sole proprietors, partners, members of LLCs, and corporate officers who own at least 50% of a company can opt out of coverage.
A: No, you cannot waive workers compensation claim rights in California in most cases. It is generally illegal to ask employees to sign a waiver to not receive workers compensation benefits. The only exception to this is if a board member, executive owner, or executive officer wishes to waive their benefits.

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