Do I need a notary for the Homeowner Workers’ Compensation Exemption Affidavit?

The form has no notary block, and its signature area asks for the homeowner’s signature and date. It also states that, once notarized, BP-1 serves as an exemption.

Who can use the BP-1 affidavit?

The form is for an owner of a one- to four-family, owner-occupied residence, including a condominium, who is listed as general contractor on the building permit and meets a listed exemption condition.

What information does the form ask for?

It asks the homeowner to check the applicable exemption condition, certify under penalty of perjury, and provide a signature, date, telephone number, printed name, and property address.

Ballston, NY · Saratoga County

No notary required

Homeowner Workers’ Compensation Exemption Affidavit

This affidavit is for qualifying homeowners who apply for a building permit and need to show an exemption from workers’ compensation coverage.

What this form is

The form is for owners of a one- to four-family, owner-occupied residence who are listed as the general contractor on a building permit and meet one of its exemption conditions. It asks the homeowner to select a qualifying condition, certify the information under penalty of perjury, and provide a signature, date, contact number, name, and property address. The form states that it cannot waive any party’s workers’ compensation rights or obligations.

Who needs it

A homeowner listed as general contractor on a building permit may use this form if the owner-occupied residence and work meet one of the listed exemption conditions.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

The signature area does not include a notary block; the form says the affidavit is under penalty of perjury and that, once notarized, BP-1 serves as an exemption.

How to submit this form

1
Download the Affidavit
Download the Homeowner Workers’ Compensation Exemption Affidavit for the building permit application.
2
Complete the Form
Check the exemption condition that applies, provide the requested homeowner and property information, and sign and date the form.
3
Review Your Eligibility
Confirm the residence and work meet one of the conditions listed on BP-1.
4
Submit to the City
Submit the completed form to the city department named on the form; check the city website for current contact details.

Frequently asked questions

Do I need a notary for the Homeowner Workers’ Compensation Exemption Affidavit?: The form has no notary block, and its signature area asks for the homeowner’s signature and date. It also states that, once notarized, BP-1 serves as an exemption.
Who can use the BP-1 affidavit?: The form is for an owner of a one- to four-family, owner-occupied residence, including a condominium, who is listed as general contractor on the building permit and meets a listed exemption condition.
How do I submit the exemption affidavit?: Submit it to the city department named on the form; check the city website for current contact details.
What information does the form ask for?: It asks the homeowner to check the applicable exemption condition, certify under penalty of perjury, and provide a signature, date, telephone number, printed name, and property address.

Need something notarized?

This Homeowner Workers’ Compensation Exemption Affidavit doesn’t need a notary — but if you have another Ballston form that does, a commissioned online notary can help.