Madisonville, KY · Hopkins County
Contractors & Sub-Contractors Workers Compensation Verification Form
This form records general contractor and subcontractor business license, contact, and workers compensation information for a project, and includes a sworn signature for the general contractor.
- 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
The City of Madisonville form collects business license, address, phone, and workers compensation company details for the general contractor and subcontractors, with spaces to identify trade work. It also has a signature and date line for the general contractor and a sworn-and-subscribed block for notarization, so it can be completed as part of a city project submission.
Who needs it
A general contractor completing this Madisonville form for a project should provide the requested information for the contractor and listed subcontractors.
Why it needs a notary
The form carries a sworn-and-subscribed jurat; the general contractor signs and swears to the form before the notary.
How to get this notarized
- 1
Download The Form
Get the City of Madisonville Contractors & Sub-Contractors Workers Compensation Verification Form.
- 2
Fill In Contractor Details
Enter the general contractor's business license, address, phone number, and workers compensation company.
- 3
Add Subcontractor Information
Complete applicable subcontractor details and identify the listed trade work.
- 4
Book An Online Notary
Arrange a remote notarization for the form's sworn-and-subscribed jurat.
- 5
Sign On Video
Sign and swear to the form in the online notary session.
- 6
Submit To The City
Submit the completed form to the City of Madisonville as part of your project paperwork.
Preview the form
The blank PDF straight from Madisonville. 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 complete the workers compensation verification form?
- Enter the general contractor and subcontractor business, contact, and workers compensation company details, identify the trades, then sign and swear to the form before a notary.
- Do I need to include subcontractor information?
- The form provides fields for subcontractor business licenses, addresses, phone numbers, workers compensation companies, and trade categories. Complete the applicable fields for the project.
- Can I sign this form with an online notary?
- Kentucky authorizes its notaries to perform online notarizations through online notary public registration. A commissioned online notary can conduct the notarization remotely; confirm with the city or county clerk if unsure.
- Who signs the notarized section?
- The general contractor signs and swears to the form. The notary completes the sworn-and-subscribed section and commission expiration information.