Get Tn Ss-4523 2019-2025

The TN Ss-4523 form is essential for individuals seeking workers' compensation exemption in the construction industry in Tennessee. This guide provides clear, step-by-step instructions to help you navigate the online filling process with ease.

Follow the steps to fill out the form accurately.

1. Click ‘Get Form’ button to access the TN Ss-4523 form and open it in your preferred online editor.
2. Complete your applicant information by entering your first name, last name, middle initial, date of birth, phone number, last four digits of your Social Security number, and email address.
3. Input your physical address, including street address, city, state, and zip code. If different, provide your mailing address along with the same details.
4. In the initial qualification section, check the appropriate box that describes your role in the construction industry (e.g., officer of a corporation, member of an LLC, sole proprietor, etc.).
5. Fill in your business entity information by entering the business entity name, SOS control number, and federal EIN from the IRS. Attach the IRS 147(c) letter as required.
6. In the initial state board for licensing contractors section, check the box that corresponds to your business licensing status. If applicable, include your license number and expiration date.
7. Provide your local business license information in the designated areas, including county, city or town, license numbers, and expiration dates as necessary.
8. Finalize your application by checking the boxes in the attestation section to confirm you meet all exemption requirements and understand the implications. Add your signature and date.
9. Once you have filled out all necessary fields, review the entire form for accuracy, then save your changes. You can download, print, or share the completed form as necessary.

Begin completing your TN Ss-4523 form online today for a seamless registration experience.