Follow the steps to complete the affidavit accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by locating the signature field for the exempt private employer. This is where the employer must sign to verify their exemption status. Ensure that the signature is clear and legible.
3. In the next field, print the name of the exempt private employer. This should be the full legal name of the individual, firm, or corporation seeking the exemption.
4. Locate the section where you declare the accuracy of the document. The authorized officer or agent must sign here, indicating they have the authority to execute this affidavit.
5. Under the signature of the authorized officer or agent, print their name and title. It is important to include the correct title to affirm their position in relation to the organization.
6. You will need to date the declaration under penalty of perjury. Fill in the date of execution, ensuring it is accurate and current.
7. Finally, prepare for the notarization section by having a notary public present. They will need to complete their section, including their signature, printed name, and the expiration date of their commission.
8. Once all sections are completed, save changes to the form. You may then download, print, or share the completed affidavit as required.

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