Dcrb form 2025

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The document outlines an agreement allowing up to eight executive officers of a corporation or four members of an LLC in Delaware to opt out of the state's Workers' Compensation Law. It specifies the eligibility criteria, the process for electing this exclusion, and the necessary documentation required for compliance. Additionally, it highlights that construction corporations/LLCs have different exclusion limits and emphasizes the need for proper submission of forms to insurance carriers.

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Click ‘Get Form’ to open the dcrb form in the editor.
Begin by entering the 'Name of business' and 'Address of business' in the designated fields. Ensure all information is accurate for proper identification.
Provide your 'Federal Employer Identification Number' in the specified area. This is crucial for tax and identification purposes.
Indicate whether your business has employees (other than those listed) by checking the appropriate box. This helps clarify your coverage needs.
Select the type of business from the options provided: Corporation Not Subject to Title 30, Corporation Subject to Title 30, or Limited Liability Company (LLC). Each option has specific exclusion limits.
Have a representative of the corporation or LLC sign and date the form in the designated signature area, confirming their authority to make this election.
List each executive officer or LLC member electing not to be subject to Delaware Workers Compensation Law, including their names, titles, signatures, and stockholder status.

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Versions	Form popularity	Fillable & printable
2009	4.8 Satisfied (197 Votes)

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