Workers Compensation Exemption Form

Workers Compensation Exemption Form
Company Name
Jetlock Corp
Federal Employer ID
1231279878291
Business Address
54 Benson Park Drive
Neverstink, New York, 12765
State where Incorporated
New York
Phone Number
(405) 395-3405

Organization Information

Date of Incorporation
03/16/2016
Entity Type
Partnership
Employee Count
23
Total Number of Partners Electing Coverage
2
Number of Partners
2
Description of business operation and work process including the type of work performed by workers
Aircraft cleaning and detailing services.
Exemption qualification of organization:
Casual employees with irregular schedules.
Item - signature 0
Representative
Mark A. Coon
Date
03/27/2020
Create your own automated PDFs with Jotform PDF Editor
About this template
A workers compensation exemption form is a document used for exemption application by a company or organization for providing workers compensation. This means that employers will not shoulder the employee's work-related injuries and illnesses. State governments usually require companies or organizations to shoulder these, however to such exceptions, companies or organizations are allowed to be exempt.

This workers compensation exemption form PDF template serves a quick form tool that can help produce the document in minutes. Whether you are an organization processing the application or the applicant that would like to get a certification, this template can be yours for free. Just copy this template to your Jotform account, modify it to your preference, and start receiving form submissions for processing applications.

Categories
Details
2,725 Clone
Created by
EdwardWrighton
Related templates
Hourly Invoice Template - PDF Templates

Hourly Invoice Template

This Hourly Invoice Template consists of all the elements needed to create a professional and accurate hourly invoice that you can send to your clients or employees. With Jotform's Hourly Invoice template, there's no need to manually create a document from scratch each time you have a project or task.

Go to Category:Business
Employment Contract Template - PDF Templates

Employment Contract Template

Generate an employment contract template in seconds. Drag and drop to customize. Fill out and sign from any device. No coding needed.

Go to Category:E-SignGo to Category:Human Resources
Professional Employee Record Template - PDF Templates

Professional Employee Record Template

Professional Employee Record Template will highly ease your process, as you will be able to view each employee's information in one interface if you are running a business or working in an HR department.

Go to Category:Human Resources
Doctors Excuse for Work - PDF Templates

Doctors Excuse for Work

Create a professional doctor’s note to excuse your patients from work. View and create from any desktop, tablet, or mobile device. Drag and drop to design.

Go to Category:E-SignGo to Category:Employee Records
Training Record Template - PDF Templates

Training Record Template

Keep track of employee training. Generate PDF training records automatically. Collect information and e-signatures. Easy to customize. No coding.

Go to Category:Human Resources
Fillable Free Pay Stub - PDF Templates

Fillable Free Pay Stub PDF Template

Generate PDF pay stubs online with a free Pay Stub Template. Easy to customize. Set up an autoresponder to send them to employees automatically.

Go to Category:Employee Records

These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.