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How to fill out the Pa Libc 14b Form online
The Pa Libc 14b Form is an important document for individuals seeking to provide an affidavit and waiver of workers' compensation benefits in Pennsylvania. This guide will help you navigate the online form-filling process efficiently and effectively.
Follow the steps to complete the Pa Libc 14b Form online.
- Click the ‘Get Form’ button to access the form and open it in the designated online editor.
- Review the form’s header section, where you will find the title and reference information. Ensure that you are looking at the correct version of the Pa Libc 14b Form.
- In the first section of the form, input your personal details including your full name, address, phone number, and email address. Make sure that all contact information is accurate to avoid any issues with processing.
- Next, provide information regarding your religious sect, if applicable. There should be designated fields for specifying the name and any relevant details associated with your sect.
- Continue to the affidavit section, where you will need to affirm your understanding of the benefits you are waiving. Carefully read the statements and check the appropriate boxes.
- Lastly, review the form for completeness and accuracy. After ensuring all information is correct, you will have the option to save changes, download, print, or share the form through the online platform.
Complete your Pa Libc 14b Form online today to streamline your process.
Exemptions include: people covered under other workers' compensation acts, such as railroad workers, longshoremen and federal employees; domestic servants (coverage is optional); agricultural workers who work fewer than 30 days or earn less than $1,200 in a calendar year from one employer; and employees who have ...
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