East McKeesport, PA · Allegheny County
Pennsylvania Workers’ Compensation Exemption Waiver
This notarized waiver records an applicant’s claimed workers’ compensation exemption for a building permit, and is completed by an eligible contractor, property owner, or religious-exemption applicant.
- 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 lets an applicant state that they qualify for a workers’ compensation exemption, such as a contractor with no employees, a property owner acting as a self-contractor, or an applicant claiming a religious exemption. The Code Enforcement Agency says all applicants must complete the notarization section. For a building permit, the form also notes that proof of workers’ compensation insurance is required for workers outside the sole-proprietor exemption.
Who needs it
Applicants claiming an exemption from workers’ compensation coverage, including eligible contractors with no employees and property owners acting as self-contractors, complete this waiver.
Why it needs a notary
The form contains a subscribed-and-sworn jurat; the named applicant swears the information is true and signs in the presence of a notary.
How to get this notarized
- 1
Download the Waiver
Get the Pennsylvania Workers’ Compensation Exemption Waiver from the East McKeesport form source.
- 2
Complete the Applicant Details
Enter your applicant and business information, address, contact details, and applicable exemption selection.
- 3
Book an Online Notary
Schedule a remote session with a commissioned online notary and have identification ready.
- 4
Sign on Video
Wait to sign until the notary instructs you during the session, then swear that the information is true.
- 5
Submit to the City
Submit the notarized waiver through the building permit process and check whether additional insurance proof is needed.
Preview the form
The blank PDF straight from East McKeesport. 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 get the waiver notarized online?
- Complete the form, then book a session with a commissioned online notary. You must swear that the information is true and sign during the video session.
- Do I need to sign the waiver in front of a notary?
- Yes. The form says all applicants must complete the notarization section and swear the information is true before signing in the presence of a notary.
- Can I use an online notary for this form?
- Pennsylvania authorizes remote online notarization for its own notaries under 57 Pa.C.S. §306.1. Ask the Code Enforcement Agency whether it accepts this form with an online notarization.
- What should I do after notarizing the waiver?
- Submit the completed waiver as part of your building permit process. The form also notes that proof of workers’ compensation insurance is required for workers outside the sole-proprietor exemption; confirm with the city, borough or township if unsure.