Massachusetts workers comp affidavit fillable 2007 form-2026

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  1. Click ‘Get Form’ to open the Massachusetts Workers Comp Affidavit in our editor.
  2. Begin by entering your name, address, and phone number in the Applicant Information section. Ensure all details are printed legibly.
  3. Indicate your employment status by checking the appropriate box: general contractor, sole proprietor, homeowner, or corporation. If applicable, provide details about your employees and subcontractors.
  4. Specify the type of project you are undertaking by selecting one from the list provided. This is a required field.
  5. If you are an employer providing workers' compensation insurance, fill in your insurance company name, policy number, and job site address. Attach a copy of your workers’ compensation policy declaration page.
  6. Finally, certify that the information is true by signing and dating the affidavit before submitting it to the relevant city or town office.

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Versions Form popularity Fillable & printable
2019 4.9 Satisfied (59 Votes)
2013 4.8 Satisfied (486 Votes)
2007 4 Satisfied (57 Votes)
2006 4 Satisfied (33 Votes)
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