Monroe, NC · Union County
Affidavit for Workers’ Compensation Coverage
This affidavit records workers’ compensation coverage details for the people performing permitted work and is completed by a building permit applicant in Monroe.
- 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
Monroe’s affidavit asks the building permit applicant to identify whether the contractor, owner, or their subcontractors have workers’ compensation coverage, including whether any coverage has been waived. The form accompanies a building permit application, and the Inspection Department may require proof of coverage or waivers before issuing the permit or while permitted work is underway.
Who needs it
A contractor, owner, or authorized officer or agent applying for a Monroe building permit for work performed by people or subcontractors.
How to get this notarized
- 1
Download The Affidavit
Get the Workers’ Compensation Coverage Affidavit from Monroe’s document page.
- 2
Fill In The Form
Enter the building permit and applicant details, and select the coverage statement that matches the permitted work.
- 3
Book An Online Notary
Arrange notarization with a commissioned online notary and confirm with the city that it will accept the notarized form.
- 4
- 5
Submit It To The City
Submit the completed affidavit with the building permit application.
Preview the form
The blank PDF straight from Monroe. 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 the workers’ compensation affidavit?
- Fill in the permit and applicant details, select the statement that applies to the workers and subcontractors, then sign and swear to the affidavit before a notary.
- Do I need to sign this affidavit in front of a notary?
- Yes. The form includes a jurat stating that it is sworn to and subscribed before a notary public. Sign it before the notary.
- Can I use an online notary for this Monroe form?
- North Carolina’s enacted remote electronic notarization program has not launched. Emergency video notarization requires both the signer and notary to be in North Carolina and is not remote online notarization. Confirm acceptance with the city before booking a commissioned online notary.
- What if I’m unsure which coverage statement to select?
- The form lists statements about employee counts, subcontractors, insurance, and waivers. Review the facts for the permitted work; confirm with the city or town if unsure.
Other forms in Monroe
Affidavit for Workers’ Compensation Coverage in other North Carolina cities
Each city publishes its own version of this form. Pick the city where you’re filing.