The Arkansas Application for Certificate of Non-Coverage (2-Sided) Required Notary Statement is a form required for employers in the state of Arkansas who need to obtain proof that they do not provide workers’ compensation insurance for their employees. This form must be completed and notarized in order to be accepted by the Arkansas Workers’ Compensation Commission. The form consists of two sides: the Certificate of Non-Coverage and the Notary Statement. On the Certificate of Non-Coverage side, the employer must provide their business information including the name, address, and contact information of the business, and the name and title of the person signing the form. They must also indicate whether the business is a sole proprietorship, partnership, corporation, or other entity. The Notary Statement side must be completed and notarized by an Arkansas notary public and must include the notary’s name, signature, the date of notarization, and a physical description of the signer. There are three types of Arkansas Application for Certificate of Non-Coverage (2-Sided) Required Notary Statement forms available: one for sole proprietorship, one for partnerships, and one for corporations and other entities.