Get Tnbeartngovwcdefaultaspx Form

Completing the Tnbeartngovwcdefaultaspx Form is an essential step for individuals seeking a subsequent workers’ compensation exemption in Tennessee. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently.

Follow the steps to complete your application successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in an online editor or completing tool.
2. Enter your initial registration control number, which can be found on your workers’ compensation registration card.
3. Provide your full legal name, including your first name, middle initial, and last name.
4. Input your date of birth using the format: two-digit month, two-digit day, and four-digit year.
5. Enter the last four digits of your Social Security Number. Ensure the complete SSN is not submitted to avoid rejection.
6. Fill in your telephone number, including the area code, to ensure you can be reached.
7. Provide a valid email address where you can be contacted.
8. Enter your physical address, including the street address, city, state (two-letter abbreviation), and ZIP code. Do not use a post office box.
9. For the mailing address, specify if it is the same as your physical address or provide an alternate mailing address.
10. Select one qualification under which you are applying for the exemption and ensure that you meet the criteria.
11. Input the business entity name exactly as registered with the Secretary of State.
12. Enter the Secretary of State Control number associated with your business entity, noting that sole proprietors can write ‘not required.’
13. Fill in the Federal Employer Identification Number (FEIN) assigned to your business entity. Ensure this is not your personal Social Security Number.
14. Complete the licensing information regarding the State Board for Licensing Contractors, including checking the appropriate box and entering your license details.
15. Provide information on any required local business licenses, including county and city information, license numbers, and expiration dates.
16. Check both attestation boxes to confirm your understanding of the requirements and the consequences of false statements.
17. Sign and date the application to certify your submission.
18. Once all fields are completed, review the form for accuracy, then save your changes, download, print, or share the form as necessary.

Complete your Tnbeartngovwcdefaultaspx Form online today to ensure a smooth application process.