Affidavit Of Exemption For Workers Compensation Insurance {WC-134}

WC-134 - AFFIDAVIT OF EXEMPTION FOR WORKERS’ COMPENSATION INSURANCE PURSUANT TO § 287.061, RSMo. This form is issued by the Missouri Department of Labor and Industrial Relations, Division of Workers’ Compensation, for use by contractors in the construction industry who are exempt from carrying workers’ compensation coverage under §287.061, RSMo. This affidavit is submitted when applying for a city or county business or occupational license to declare exemption based on business structure — such as a sole proprietor with no employees, a partnership with no employees, or a corporation with two owners who are the only employees. The form includes legal references explaining statutory employment, exemptions for “S” corporations, and penalties for false statements. Fraudulent or misleading filings may result in misdemeanor or felony charges under Missouri law. www.FormsWorkflow.com