Affidavit of Exemption to Show Specific Proof of Workers’ Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence
| Homeowners of a 1, 2, 3 or 4 Family, Owner-occupied Residence who are serving as their own general contractor on small jobs that require a building permit may be eligible to fill out this form as proof that they do not need a statutory workers’ compensation policy |