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

No. The form has no notary block and asks the homeowner to sign and date it. Although its text says “once notarized,” it does not identify a notarial step or require notarization.

When can a homeowner claim an exemption?

The form lists doing all the work, not hiring or paying anyone, or having current homeowners insurance and paying workers for fewer than 40 total hours per week.

Groton, NY · Tompkins County

No notary required

Affidavit of Exemption for Owner-Occupied Residence

This affidavit is for homeowners applying for a building permit for a one- to four-family owner-occupied residence who qualify for a workers’ compensation coverage exemption.

What this form is

The BP-1 affidavit lets an eligible homeowner state why they are exempt from showing specific proof of workers’ compensation coverage when applying for a building permit. It applies when the homeowner performs all the work, does not hire or pay anyone, or has qualifying homeowners insurance and pays workers for fewer than 40 total hours per week. The form asks for the exemption basis, homeowner’s signature and date, telephone number, and property address.

Who needs it

A homeowner listed as the general contractor on a building permit for a one- to four-family owner-occupied residence may file this form if an exemption condition applies.

How to submit it

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

About notarization

This document has no notary block and includes a homeowner signature and date; its text says “once notarized,” but does not identify a notarial step or require notarization.

How to submit this form

1
Download The Affidavit
Download the BP-1 affidavit PDF.
2
Complete The Form
Select the applicable exemption basis and enter the homeowner’s name, telephone number, and property address.
3
Sign And Date
The homeowner signs and dates the affidavit.
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 Workers’ Compensation Exemption Affidavit?: No. The form has no notary block and asks the homeowner to sign and date it. Although its text says “once notarized,” it does not identify a notarial step or require notarization.
Who can use this affidavit?: A homeowner listed as the general contractor on a building permit for a one- to four-family owner-occupied residence may use it if one of the stated exemption conditions applies.
When can a homeowner claim an exemption?: The form lists doing all the work, not hiring or paying anyone, or having current homeowners insurance and paying workers for fewer than 40 total hours per week.
How do I submit the affidavit?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Affidavit of Exemption for Owner-Occupied Residence doesn’t need a notary — but if you have another Groton form that does, a commissioned online notary can help.