Manchester, CT · Hartford County
Form 7C Workers’ Compensation Coverage Affidavit
Form 7C is a sworn affidavit for a general contractor or principal employer who has properly excluded themselves from workers’ compensation coverage and needs to apply for a building permit.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Manchester’s Form 7C is for a general contractor or principal employer who has properly excluded themselves from workers’ compensation coverage by filing the applicable Form 6B or 6B-1 with the Workers’ Compensation Commission. The signer attests that they will require proof of workers’ compensation insurance from every contractor, subcontractor, or other worker before work begins at the project site. The form is submitted to the building official when applying for a building permit.
Who needs it
A general contractor or principal employer who has properly excluded themselves from coverage and is applying for a building permit for work at the listed property needs this form.
Why it needs a notary
The form carries a sworn affidavit jurat; the general contractor or principal employer signs the affidavit before a notary public or Commissioner of the Superior Court.
How to get this notarized
- 1
Download Form 7C
Download Manchester’s Form 7C and its instructions.
- 2
Fill Out the Form
Enter the requested business, applicant, and property information; select the applicable options and complete the affidavit details.
- 3
Book an Online Notary
Schedule a session with a commissioned online notary and have an acceptable photo ID ready.
- 4
Sign on Video
Sign the affidavit during the live video session when directed by the notary.
- 5
Submit to the City
Give the completed Form 7C to the building official with your building permit application.
Preview the form
The blank PDF straight from Manchester. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I get Form 7C notarized online?
- Complete the form, then book a commissioned online notary. Sign the affidavit during your video session, after the notary verifies your identity and administers the oath.
- Do I need to notarize Form 7C?
- The form says to sign the affidavit in the presence of a notary public or Commissioner of the Superior Court, if applicable. Check the form instructions and your situation before booking.
- Who signs the Form 7C affidavit?
- The general contractor or principal employer who has properly excluded themselves from workers’ compensation coverage signs the affidavit and attests they will require proof of insurance from workers.
- Can I use online notarization for this Connecticut form?
- Connecticut authorizes its own notaries to perform remote online notarizations under Public Act 23-28, effective October 1, 2023. The form is for an affidavit, not a document type excluded by that law.
- Where do I submit the completed Form 7C?
- The directions say to give Form 7C to the building official when applying for a building permit. Confirm with the town clerk if unsure.
Form 7C Workers’ Compensation Coverage Affidavit in other Connecticut cities
Each city publishes its own version of this form. Pick the city where you’re filing.