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Workers Comp Affidavit

State:
Missouri
Control #:
MO-SKU-2153
Format:
PDF
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Description

Affidavit of Exemption For Workers Compensation Insurance The Missouri Affidavit of Exemption For Workers Compensation Insurance is a document that employers must file with the Missouri Department of Labor and Industrial Relations to exempt any business that only employs themselves and/or their spouse from having to purchase workers’ compensation insurance. There are two types of Missouri Affidavit of Exemption For Workers Compensation Insurance: 1) Sole Proprietor Affidavit of Exemption; and 2) Spouse of Sole Proprietor Affidavit of Exemption. The Sole Proprietor Affidavit of Exemption must be completed by the sole proprietor and must include the name, address, and Social Security number of the sole proprietor. The Spouse of Sole Proprietor Affidavit of Exemption must be completed by the spouse of the sole proprietor and must include the name, address, and Social Security number of the spouse. Both affidavits must be signed and notarized before they can be submitted to the Missouri Department of Labor and Industrial Relations. Upon approval, the employer is exempt from purchasing workers’ compensation insurance and from paying the related premiums.

The Missouri Affidavit of Exemption For Workers Compensation Insurance is a document that employers must file with the Missouri Department of Labor and Industrial Relations to exempt any business that only employs themselves and/or their spouse from having to purchase workers’ compensation insurance. There are two types of Missouri Affidavit of Exemption For Workers Compensation Insurance: 1) Sole Proprietor Affidavit of Exemption; and 2) Spouse of Sole Proprietor Affidavit of Exemption. The Sole Proprietor Affidavit of Exemption must be completed by the sole proprietor and must include the name, address, and Social Security number of the sole proprietor. The Spouse of Sole Proprietor Affidavit of Exemption must be completed by the spouse of the sole proprietor and must include the name, address, and Social Security number of the spouse. Both affidavits must be signed and notarized before they can be submitted to the Missouri Department of Labor and Industrial Relations. Upon approval, the employer is exempt from purchasing workers’ compensation insurance and from paying the related premiums.

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Workers Comp Affidavit