Aurora, MO · Lawrence County
Affidavit of Exemption for Workers’ Compensation Insurance
This sworn affidavit lets a construction contractor without proof of workers’ compensation insurance explain why the business is exempt when applying for an occupational or business license.
- 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 affidavit identifies the contractor and business, and asks the affiant to select and explain the basis for claiming an exemption from workers’ compensation insurance. The form says contractors applying for a city or county occupational or business license must file it when they lack proof of coverage; without proof or the completed affidavit, the license may be denied. Its attached pages explain key definitions and guidelines for evaluating an exemption.
Who needs it
A construction contractor applying for an occupational or business license who lacks proof of workers’ compensation insurance coverage may need to submit this affidavit.
How to get this notarized
- 1
Download The Form
Get the three-page Affidavit of Exemption for Workers’ Compensation Insurance.
- 2
Fill In The Affidavit
Complete the affiant and business information, select the exemption reason, and review the attached guidelines.
- 3
Book An Online Notary
Schedule a remote notarization for the affidavit’s sworn statement.
- 4
Sign On Video
Sign and swear to the affidavit before the notary during your online session.
- 5
Submit To The City
File the completed affidavit with the appropriate licensing office as part of your application.
Preview the form
The blank PDF straight from Aurora. 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 this workers’ compensation exemption affidavit?
- Enter the affiant and business details, select the applicable exemption reason, complete the oath before a notary, and submit the affidavit with your license application.
- Do I need to file this affidavit with my license application?
- The form says a construction contractor applying for a city or county occupational or business license must file it if they do not have proof of workers’ compensation coverage. Confirm your situation with the licensing office.
- Can I sign this affidavit with a commissioned online notary?
- Missouri law authorizes remote online notarization by Missouri notaries under RSMo §486.1100 to §486.1205. Ask the receiving office whether it accepts the remotely notarized affidavit.
- Where do I submit the completed form?
- The form describes filing the affidavit with the city or county when applying for an occupational or business license. Confirm the submission process with the licensing office; confirm with the city or town if unsure.
Affidavit of Exemption for Workers’ Compensation Insurance in other Missouri cities
Each city publishes its own version of this form. Pick the city where you’re filing.