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Workers Comp Exemption application Form: What You Should Know
Applicants do not need to fill out an application for an exemption from workers' comp or any other requirements. EE-101 To apply for an exemption from workers' compensation law, use the online Workers' Compensation Application (EE-101), which can be found here. When completing the online application, enter the information required by the form for exemption for each person or other entity involved. This form can be downloaded, filled out and mailed or dropped off at the Department of Financial Services, P.O. Box 500, Blevins, FL 33525. Exemption from Workers' Compensation — Georgia Department of Labor and Industry If an organization, including individuals or corporations, that has no employees is exempt from providing Workers' Compensation Insurance benefits on their own behalf, they may be exempt from the following Georgia Employee Pre-Exemption Requirements and Application Form are completed and the information is sent to the Georgia Department of Labor and Industry by the organization's payroll service. Employer Identification You must be the principal officer of the company/organization for which you are seeking exemption from providing workers' compensation insurance and the principal officer of that entity if the person seeking exemption is not the principal officer of a corporation. Required Forms Please complete the required forms by using this link. Additional Forms An employer identification number should be on all Forms of Employee Identification. A complete copy of this form is required. Payroll Service Request If the company or agency who seeks exemption from workers' compensation providing workers' compensation insurance on behalf of individual workers is a non-profit agency, a business shall provide payment of wages, wages for overtime, wages and wages for travel, and a monthly bill showing payment for benefits. If the company or agency seeking exemption from workers' compensation will be providing their employees with benefits, such as medical, disability, or life insurance, and insurance paid to the employers by the state, a business providing that benefits shall provide a copy of the state workers' compensation insurance certificate which meets the requirements listed here. Please note that a copy of this form must be included with the request for payment for benefits.
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