Eing the Licensed Contractor License Number do hereby aver under penalties of perjury that the person(s), firm(s), or corporation(s) performing the work set forth in the permit has/have not more than (2) employees while working on the project for which this permit is sought. This document must be signed by the owner of the proprietorship, partner in the partnership, officer of the corporation or manager of the L.L.C. appearing as the contractor on the building permit. Signatures are be witne.
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How to fill out the NC Affidavit Of Workers Compensation Exemption - Wake County online
The NC Affidavit Of Workers Compensation Exemption is a crucial form for contractors seeking a building permit in Wake County. This guide provides a clear and structured approach to filling out the affidavit online, ensuring that users can complete the form accurately and efficiently.
Follow the steps to fill out the NC Affidavit Of Workers Compensation Exemption online
- Click ‘Get Form’ button to obtain the form and open it in the editing interface.
- Fill in the 'Building Permit Number' field at the top of the form, ensuring accuracy as this identifies your specific permit.
- Indicate whether you are an 'Unlicensed Contractor' or a 'Licensed Contractor' by checking the appropriate box.
- If you are a licensed contractor, provide your 'License Number' in the designated field.
- In the section that states 'do hereby aver under penalties of perjury,' confirm the number of employees by verifying that the person(s), firm(s), or corporation(s) performing the work have no more than two employees.
- The form must be signed by a designated person: the owner of the proprietorship, a partner in the partnership, an officer of the corporation, or the manager of the LLC appearing as the contractor on the building permit.
- Complete the fields for 'Firm Name' and 'Completed By,' including the title of the individual completing the form.
- Provide a signature in the designated area and fill in the date of signature.
- Arrange for the document to be witnessed by a Permit Staff member or notarized if required.
- Once all fields are complete, you can save changes, download the completed form, print it, or share it as necessary.
Start completing the NC Affidavit Of Workers Compensation Exemption online today!
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What is a Form 33 Workers Compensation NC?
Form 33 - This is the Request that Claim Be Assigned for Hearing. This form can be filed to request a hearing if you have a dispute with your employer concerning your medical care or other issues. This form can also be filed if you are not receiving all, or some, of the benefits to which you are entitled.
Does a sole proprietor need workers' comp in North Carolina?
The North Carolina Workers' Compensation Act (NCWCA) states that all businesses with three or more employees must carry workers' compensation insurance. This includes businesses operating as: Corporations. Sole proprietorships.
Who is required to carry workers comp in North Carolina?
The North Carolina Workers' Compensation Act requires that all businesses that employ three or more employees, including those operating as corporations, sole proprietorships, limited liability companies and partnerships, obtain workers' compensation insurance or qualify as self-insured employers for purposes of paying ...
Who is exempt from workers' compensation in NC?
Those businesses that employ three or more employees are required to carry workers compensation insurance except agricultural employment with fewer than 10 employees, certain sawmill and logging operations and all domestic employees are exempt.
What is the penalty for not having workers compensation in North Carolina?
Qualifying North Carolina employers who fail to secure workers' comp insurance can be charged with the following penalties: Class H Felony. Fines of up to $36,500 per year ($100 per day), even if no workplace injuries took place.
Do independent contractors need workers' comp in North Carolina?
Generally speaking, employers and companies in North Carolina are not required to purchase workers' compensation coverage for independent contractors, freelancers and subcontractors.
What is the minimum payroll for workers comp officers in NC?
Corporate Officers who are not excluded from workers' comp coverage must utilize a minimum payroll of $59,800 up to a maximum annual payroll wage of $119,600 in order to calculate the cost of workers' comp insurance.
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