Get Ss 4523 Form

Filling out the Ss 4523 Form online is an important step for individuals seeking a workers’ compensation exemption in Tennessee. This guide provides clear, step-by-step instructions to help users effectively complete the application without complications.

Follow the steps to complete the Ss 4523 Form online.

1. Click 'Get Form' button to obtain the Ss 4523 Form and open it in your preferred application.
2. Begin with the applicant information section. Enter the full legal name of the applicant, including the first name, middle initial, and last name.
3. Select the appropriate qualification that allows the applicant to be eligible for exemption.
4. Indicate whether the business has an active contractor’s license and complete the necessary fields as applicable.
5. Attest and check the required boxes to confirm understanding of the exemption conditions and responsibilities.
6. Ensure to sign and date the application before submission.
7. Calculate the filing fee based on licensing status: $100 for applicants without a license, or $50 for those with a license. Include payment with the application.
8. Save changes, download the completed form, and print a copy for your records before submitting it.

Start completing your Ss 4523 Form online today to secure your workers’ compensation exemption.