Trappe, PA · Montgomery County
Workers’ Compensation Information Form
Applicants provide Trappe Borough with work-site, applicant, and workers’ compensation details using this form.
What this form is
Trappe Borough requires all applicants to complete this form with the site address and applicant information. Contractors provide insurance details, while applicants claiming an exemption identify the applicable reason; some exemption claims require supporting proof to be attached. The form states that work may be stopped when non-exempt parties lack workers’ compensation insurance or have not submitted the proper exemption form.
Who needs it
All applicants complete the form, including contractors providing insurance information and applicants claiming a workers’ compensation exemption.
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 form has no notary block; the applicant signs it, and exemption claims may require supporting proof to be attached.
How to submit this form
- 1
Download The Form
Download the Workers’ Compensation Information Form.
- 2
Complete The Applicant Details
Enter the site address and applicant information; contractors also complete the insurance section.
- 3
Gather Supporting Documents
Attach any proof requested for the exemption claimed or an insurance certificate, as applicable.
- 4
Sign And Submit
Sign the form and submit it 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 Information Form?
- No. The form has no notary block. The applicant signs it; applicants claiming an exemption may need to attach supporting proof.
- How do I submit the Workers’ Compensation Information Form?
- 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 for the site address and applicant details. Contractors provide workers’ compensation insurance information, while applicants claiming an exemption identify a reason.
- What attachments may be needed?
- Depending on the exemption claimed, the form calls for a copy of an exemption notification or proof of partnership. Contractors may also attach an insurance certificate.