New York · Form type
Workers’ Compensation Exemption Affidavit
This affidavit lets an owner of a one- to four-family owner-occupied residence explain why workers’ compensation coverage is not required when applying for a building permit.
Available in 20 cities.
Cities offering this form
Angola
Workers’ Compensation Exemption Affidavit
Baxter Estates
Workers’ Compensation Exemption Affidavit
Bayville
Workers’ Compensation Exemption Affidavit
Chautauqua
Workers’ Compensation Exemption Affidavit
Deerpark
Workers’ Compensation Exemption Affidavit
Elmira Heights
Workers’ Compensation Exemption Affidavit
Florida
Workers’ Compensation Exemption Affidavit
Groton
Workers’ Compensation Exemption Affidavit
Harriman
Workers’ Compensation Exemption Affidavit
Head of the Harbor
Workers’ Compensation Exemption Affidavit
Jay
Workers’ Compensation Exemption Affidavit
Lynbrook
Workers’ Compensation Exemption Affidavit
Milan
Workers’ Compensation Exemption Affidavit
Morristown
Workers’ Compensation Exemption Affidavit
North East
Workers’ Compensation Exemption Affidavit
Northumberland
Workers’ Compensation Exemption Affidavit
Prattsville
Workers’ Compensation Exemption Affidavit
Rushville
Workers’ Compensation Exemption Affidavit
Tuckahoe
Workers’ Compensation Exemption Affidavit
Village of Pawling
Workers’ Compensation Exemption Affidavit