Do I need a notary for the Contractor’s Certification of Workers’ Compensation Liability?

No. The form calls for the applicant’s signature and date, not notarization. The instructions also say not to attach any documents.

Who must file Form 61-A?

A contractor must file this form in each locality where they apply for or renew a business license.

What information does the certification ask for?

It asks for applicant and business details, business status and trade, workers’ compensation coverage information, and whether coverage is not required.

How do I submit Form 61-A?

Complete and sign the form, date it, and present it to the licensing authority. Do not attach documents to the certificate.

Berryville, VA · Clarke County

No notary required

Contractor’s Certification of Workers’ Compensation Liability (Form 61-A)

Contractors file this certification with each locality where they apply for or renew a business license, reporting their business details and workers’ compensation coverage.

What this form is

This form certifies a contractor’s workers’ compensation liability and must be filed in each locality where the contractor applies for or renews a business license. It asks for applicant and business information, the type of trade, insurance or other coverage details, and whether coverage is not required. The applicant signs and dates the certification, then presents it to the licensing authority.

Who needs it

Contractors applying for or renewing a business license in Berryville must file this certification with the locality issuing the license.

How to submit it

Complete and sign the form, date it, and present it to the licensing authority. The instructions say not to attach any documents to the contractor’s certificate.

About notarization

This form is signed and dated without a notary; the instructions say not to attach any documents to the contractor’s certificate.

How to submit this form

1
Download the Form
Download the Contractor’s Certification of Workers’ Compensation Liability (Form 61-A) PDF.
2
Complete the Form
Provide the requested applicant, business, trade, and workers’ compensation information.
3
Sign and Date
Sign the form, print the signer’s name, and enter the date.
4
Present to the Licensing Authority
Present the completed form to the licensing authority. Do not attach documents.

Frequently asked questions

Do I need a notary for the Contractor’s Certification of Workers’ Compensation Liability?: No. The form calls for the applicant’s signature and date, not notarization. The instructions also say not to attach any documents.
Who must file Form 61-A?: A contractor must file this form in each locality where they apply for or renew a business license.
What information does the certification ask for?: It asks for applicant and business details, business status and trade, workers’ compensation coverage information, and whether coverage is not required.
How do I submit Form 61-A?: Complete and sign the form, date it, and present it to the licensing authority. Do not attach documents to the certificate.

Need something notarized?

This Contractor’s Certification of Workers’ Compensation Liability (Form 61-A) doesn’t need a notary — but if you have another Berryville form that does, a commissioned online notary can help.