Get Libc-14b Employee Affidavit And Waiver - Religious Sect - Cityofwarrenpa

Filling out the LIBC-14b Employee Affidavit And Waiver is an important step for individuals who are part of a religious sect and wish to waive their rights to workers' compensation benefits. This guide provides clear instructions on how to complete the form accurately and efficiently online.

Follow the steps to complete your affidavit and waiver online.

1. Press the ‘Get Form’ button to access the LIBC-14b document and open it for editing.
2. Begin by filling in your personal information clearly in the 'Employee' section, including your name, city or town, and the complete street address.
3. Next, input your employer's information in the designated fields, ensuring accuracy in the name, city or town, and complete street address.
4. Provide your Social Security Number in the specified area. Ensure this is entered correctly to avoid any issues later.
5. In the Waiver of Workers’ Compensation and Affidavit section, accurately fill in your name and the name of your religious sect, stating your adherence to its teachings that oppose insurance benefits.
6. Affix your signature in the designated space, and ensure to include the date of signing along with the required notarization.
7. In the Statement of Religious Sect, have your sect leader fill in their name, the sect they represent, and affirm your membership, including their signature.
8. Once all sections are filled out completely, ensure all information is accurate, then save your changes. You can choose to download, print, or share your completed form as needed.

Start completing your LIBC-14b form online today for a smooth waiver process.