Marietta, OK · Love County
Affidavit of Exempt Status Under the Workers’ Compensation Act
This affidavit lets an independent contractor request exempt status under the Workers’ Compensation Act and is signed and given to the general contractor for a job or project.
- 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 form records an independent contractor’s statements about their business, work arrangement, and understanding of workers’ compensation coverage, and includes a fact sheet to help assess independent-contractor status. It says to sign and notarize the affidavit at the start of a job or project for the contractor, then give the signed form to the general contractor. The form says it is valid for that project or similar work for the contractor for one year from notarization.
Who needs it
An independent contractor who has agreed to provide services to a contractor and is requesting consideration for exempt status may need to complete this affidavit.
How to get this notarized
- 1
Download the Form
Get the affidavit and its attached Exempt Status Fact Sheet.
- 2
Review and Fill In
Read the fact sheet and complete the affidavit details for yourself, your business, contractor, and project.
- 3
Book an Online Notary
Schedule a session with a commissioned online notary before signing.
- 4
- 5
Submit to Your Contractor
Give the signed and notarized form to your general contractor.
Preview the form
The blank PDF straight from Marietta. 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 affidavit?
- Review the affidavit and attached fact sheet, complete the requested information, and sign the affidavit before a notary at the start of the job or project. Give the signed form to your general contractor.
- Do I need to attach the Exempt Status Fact Sheet?
- Yes. The affidavit says you have read, signed, and attached the Exempt Status Fact Sheet. It advises against signing if at least six statements do not describe your business.
- Can I sign this form with an online notary?
- Oklahoma authorizes remote online notarization for notaries who meet its registration requirements. Oklahoma also recognizes notarial acts performed by a notary public or other authorized officer of another state under 49 O.S. §115.
- Where do I submit the signed affidavit?
- The form instructs you to give the signed affidavit to your general contractor. It does not direct you to file it with the city.
- How long does this affidavit apply?
- The form says it is good for the job or project, or any similar job or project performed for the contractor, for one year from the date of notarization.