Oakland County, MI · Oakland County
Sole Proprietor Worker’s Compensation Waiver Release Form
Oakland County contractors who are sole proprietors use this form to acknowledge their status and release certain claims related to contract work.
At a glance
- Issued by
- City of Oakland County · Oakland County, Oakland County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- cdn.oaklandcountymi.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form is for a sole proprietor performing work or services for Oakland County under a contract. The contractor acknowledges having no employees, agrees to hold the County harmless for injuries or illnesses connected to the contract, and agrees to notify the County before hiring anyone and secure workers’ compensation insurance before that person begins work.
Who needs it
A sole proprietor contractor performing work or services for Oakland County under a contract should complete this release.
How to submit it
Submit it to the county department named on the form; check the county website for current contact details.
About notarization
This form is signed without a notary; the contractor signs and dates it, and a witness other than a relative also signs and dates it.
How to submit this form
- 1
Download the Form
Download the Sole Proprietor Worker’s Compensation Waiver Release Form.
- 2
Complete the Form
Complete the contractor acknowledgment and sign and date the form.
- 3
Have a Witness Sign
Have a witness who is not a relative sign and date the form.
- 4
Submit to the County
Submit the completed form to the county department named on the form; check the county website for current contact details.
Frequently asked questions
- What does the Sole Proprietor Worker’s Compensation Waiver Release Form do?
- It records a contractor’s acknowledgment that they are a sole proprietor with no employees and their agreement to hold Oakland County harmless for injuries or illnesses connected to contract work.
- Who completes this waiver release?
- A sole proprietor performing work or services for Oakland County under a contract completes the form.
- Do I need a notary for the Sole Proprietor Worker’s Compensation Waiver Release Form?
- No. The contractor signs and dates the form, and a witness other than a relative also signs and dates it; no notary is indicated.
- How do I submit the waiver release?
- Submit it to the county department named on the form; check the county website for current contact details.