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PENSATION 1171 S. CAMERON STREET, ROOM 103 HARRISBURG, PA 17104-2501 (To be filed with the 304.2 Application for Religious Exception) EMPLOYE STREET ADDRESS CITY/TOWN EMPLOYER STREET ADDRESS STATE ZIP CODE CITY/TOWN STATE ZIP CODE EMPLOYE SOCIAL SECURITY NUMBER WAIVER OF WORKERS COMPENSATION AND AFFIDAVIT I, , do hereby state and affirm that I am a member of EMPLOYE . Its established tenets and.

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Workers' Comp Exemptions in Pennsylvania Sole-Proprietors and Partners who include themselves on workers' compensation coverage must use a minimum payroll amount of $58,760 and a maximum amount of 148,200 for rating their overall workers' compensation cost in 2023.

federal workers. longshoremen. railroad workers. casual workers whose employment is casual in character AND not in the regular course of the business of the employer.

Criminal Consequences Failing to carry workers' comp insurance is a criminal offense; a non-compliant employer in Pennsylvania can face fines up to $2500 and/or one year in prison for each day that the employer does not have coverage for employees.

Workers' Compensation is tax-free. In Pennsylvania, the weekly compensation rate amounts to 66% of the injured worker's average weekly wage if they earned between $810.76 and $1,621.50 prior to the injury. For workers who earn between $600.56 and $810.75, the weekly compensation rate is $540.50.

If you're self-employed, also called a sole proprietor, you don't need workers' compensation. Though Pennsylvania doesn't mandate coverage, it is available if you choose. Self-employed workers can still receive lost-wage assistance and other benefits through a workers' comp policy.

In Pennsylvania, any business that employs one or more people is required by law to provide them with workers' compensation insurance. This provides no-fault coverage for any work-related injuries or illnesses that may occur, including medical treatment and a portion of the injured worker's lost wages.

Workers' compensation coverage is mandatory for most employers under Pennsylvania law. Employers who do not have workers' compensation coverage may be subject to lawsuits by employees and to criminal prosecution by the commonwealth.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232