Get Ma Worker's Compensation Insurance Affidavit 2019-2026

Filling out the MA Worker's Compensation Insurance Affidavit online can streamline your application process and ensure compliance with Massachusetts law. This guide provides a clear, step-by-step approach to help you accurately complete the affidavit, ensuring you meet all necessary requirements.

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 with the applicant information section. Clearly print your name, address, city/state/zip, and your phone number. Ensure that the information is accurate and legible.
3. Indicate your employment status by checking the appropriate box. Choose from options such as general contractor, sole proprietor/partner, homeowner, or corporation, depending on your situation.
4. Select the type of project you are undertaking by checking the relevant box. This could include options like new construction, remodeling, or other specified tasks.
5. If you are a general contractor, provide the names of sub-contractors and confirm whether they have employees. If applicable, include their workers’ compensation policy number.
6. If you are employing workers, fill in the insurance company name, policy number or self-insurance license number, and the expiration date of your coverage.
7. Include the job site address with the corresponding city/state/zip code.
8. Attach a copy of the workers’ compensation policy declaration page to verify your coverage, ensuring it shows the policy number and expiration date.
9. Review the affidavit for completeness and accuracy. Certify the information provided by signing and dating the affidavit.
10. Finally, save your changes and proceed to download, print, or share the filled-out affidavit as needed.

Complete your documents online to simplify your workflow and comply with regulations.