Official Oklahoma Exempt Form Fill Out This Document Online

Official Oklahoma Exempt Form

The Oklahoma Exempt form, officially known as CC-FORM-36A, allows individuals or business entities to declare an exempt status under the Administrative Workers' Compensation Act (AWCA), thus not requiring them to secure workers' compensation. The form is essential for those who operate as independent contractors or under specific conditions that exclude them from the definition of "employee" as per the AWCA. Ensuring accuracy and understanding the obligations and repercussions of this declaration is critical, as false information can lead to misdemeanors or other legal consequences. Click the button below to initiate the completion of the Oklahoma Exempt form and secure your business's compliance.

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Outline

In Oklahoma, the landscape of workers' compensation includes a critical provision for individuals or business entities not required to secure compensation under the Administrative Workers' Compensation Act (AWCA) through the Affidavit of Exempt Status. Navigating the complexities of this affidavit, designated as CC-FORM-36A, is pivotal for those seeking exemption. Essential to this process is understanding the distinction between an employee and an independent contractor within the AWCA context, alongside the specific conditions under which one might qualify for exempt status. The affidavit not only requires the affiant to declare their understanding of these distinctions and their intent not to secure workers' compensation insurance but also outlines the responsibilities and repercussions associated with filing such a document. The form, which necessitates a nonrefundable filing fee, has implications that extend into aspects of legal liability, operational freedom, and financial management for both the individual and their potential contractors. It embodies a comprehensive affidavit that must be meticulously completed and filed with the Oklahoma Workers' Compensation Commission, either in person, by mail, or online, underscoring the importance of accuracy and honesty in its execution to prevent potential legal consequences.

Form Sample

THIS SPACE FOR COMMISSION USE ONLY

CC-FORM-36A

WORKERS’ COMPENSATION COMMISSION

 

1915 NORTH STILES AVENUE STE 231

File original and one (1) copy with the

OKLAHOMA CITY, OK 73105

Workers’ Compensation Commission

 

(WCC) in-person or by mail, or file online at

 

www.ok.gov/wcc.

AFFIDAVIT OF EXEMPT STATUS UNDER THE

Must be accompanied by a nonrefundable

$50 filing fee payable to the WCC.

ADMINISTRATIVE WORKERS' COMPENSATION ACT

CHECKS WILL NOT BE ACCEPTED.

 

Type of Filing (check one):  Original Affidavit of Exempt Status - Expires at midnight two (2) years from the filing date.

Renewal - Expires at midnight two (2) years from the expiration date indicated below.

If renewing a current Affidavit, provide: Affidavit # __________ and Expiration Date: _____________

I, ________________________________________, state under penalty of perjury, as follows:

1.I, ____________________________________ (Name of individual), in my individual capacity or operating as

_________________________________ (business name), have read, signed and attached the Exempt Status Fact Sheet and understand the definition of "employee" and specific exceptions to that definition found in 85A O.S. §2(18). I also understand that an Independent Contractor is one who engages to perform certain services for another, according to his own manner, method, free from control and direction of his contractor in all matters connected with the performance of the service, except as to the result or product of the work. A Contractor may be either (i) the owner of a project or job or (ii) an Independent Contractor in any tier who has subcontracted with a subcontractor.

2.I understand that based upon the representations in this Affidavit of Exempt Status ("Affidavit"), I am reques�ng that the recipient of this Affidavit consider my business to either (i) be exempt from the defini�on of “employee” or (ii) be that of an independent contractor, and that no workers' compensa�on insurance premium be charged for the services performed by my business. I do not want workers’ compensa�on insurance and understand that I am not eligible for workers’ compensa�on benefits.

3.In the event changed circumstances make securing compensation pursuant to the requirements of the Administrative Workers' Compensation Act necessary, I will execute and file a Cancellation of Affidavit of Exempt Status with the Workers' Compensation Commission. I will obtain workers’ compensation and employers’ liability insurance for my employees if I have employees, unless they are otherwise exempt from the requirements of the Administrative Workers’ Compensation Act.

4.The information I have provided is not the result of force, threats, coercion, compulsion or duress.

5.I understand that the execution of this Affidavit, if I am an independent contractor, shall establish a conclusive presumption that I am not an employee for purposes of the Administrative Workers’ Compensation Act.

6.I understand that the execution of this Affidavit shall not affect the rights or coverage of any employee of the individual or business executing this Affidavit.

7.I understand if any contractor or its insurer shall become liable under the Administrative Workers’ Compensation Act for the payment of compensation due to a compensable work related injury of my employee(s), the contractor or its insurer may recover from me the amount of such compensation paid or for which liability is incurred.

8.I understand that knowingly providing false information on an executed Affidavit of Exempt Status shall constitute a misdemeanor punishable by a fine not to exceed One Thousand Dollars ($1,000.00).

Affiant Signature

I declare under PENALTY OF PERJURY that I have examined all statements contained herein, and to the best of my knowledge and belief, they are true, correct and complete.

Affiant Name ______________________________________ Title ________________________ Phone _____________________

Business Name ____________________________________________________ Email ___________________________________

FEIN/EIN/TIN # _______________ Mailing Address ________________________________________________________________

Affiant Signature _________________________________________________________________ Date _____________________

Any person who commits workers’ compensation fraud, upon conviction, shall be guilty of a felony punishable by imprisonment, a fine or both.

It is a crime to falsify the information on this form.

Effective 1/2/19

EXEMPT STATUS FACT SHEET

Pursuant to 85A O.S., §36, any individual or business entity that is not required to secure compensation under the requirements of the Administrative Workers' Compensation Act (AWCA) may execute an Affidavit of Exempt Status. Those who are unsure as to whether they may lawfully submit an Affidavit of Exempt Status should seek competent legal advice.

Employee: 85A O.S., §2(18): The definition of "employee" includes any person, including minors, in the service of an employer under any contract of hire or apprenticeship, written or oral, expressed or implied. It excludes those whose employment is casual and not in the course of the trade, business, profession, or occupation of his or her employer. Additional, specific exceptions may be found in 85A O.S. §2(18)(b).

Independent Contractor: The AWCA does not define "independent contractor." Oklahoma law considers an independent contractor to be one who engages to perform certain services for another, according to his or her own manner and method, free from control and direction of his or her contractor in all matters connected with the performance of the service, except as to the result or product of the work. Independent Contractors are not “employees” for purposes of the AWCA.

Below are statements to help you decide if you are an independent contractor. No one statement is controlling, and your status is based on all the facts in your situation.

1.The nature of the contract between you and the contractor. For example: Is there a writen contract where you agree that you are an independent contractor? Are you a corpora�on or limited liability company? Do you maintain commercial general liability insurance or other business insurance?

2.The contractor exercises very litle control over your work. For example: By the agreement, can the contractor exercise control on the details of the work or your independence? Do you exercise control over most of the details of the work? Do you create plans or specifica�ons for the job? Do you set your own work hours?

3.You are engaged in a dis�nct occupa�on or business for others. For example: Do you work for companies or individuals other than the Contractor? Do you work for compe�tors of the Contractor? Does your business have a logo or uniform?

4.Your job is the kind of occupa�on where the work is usually performed by a specialist without supervision, and not under the direc�on of the contractor. For example: Does the Contractor supervise your work?

5.Your occupa�on requires special skills, license, educa�on or training.

6.The contractor does not supply the things needed to perform your job such as the tools and the place of work. For example: Do you supply any of the materials or tools for the work? Do you operate a vehicle owned by the contractor? Do you perform the work at your business or the contractor’s business loca�on or jobsite? Do you wear a uniform supplied by the contractor?

7.The length and dura�on of the job does not show that you are really an employee. For example: Is this a one-�me job, or will you be doing this for the contractor regularly?

8.You are paid as a separate contractor, not as an employee. For example: Do you invoice the Contractor for your services? Are you paid by the job? Do you file a federal income tax return for your business? Do you expect to receive an IRS Form 1099 from the Contractor? Does the Contractor pay your expenses?

9.Your work is not the regular business of the employer. For example: Is your work customarily done in the Contractor’s line of business or as part of the Contractor’s daily work? Have you ever been an employee of the Contractor? Do you work with other people hired by the Contractor on the work you perform?

10.You do not consider yourself an employee of the contractor. For example: Will the Contractor withhold taxes or monies from your payment? Have you ever been an employee of the Contractor? Have you or your employees ever filed an insurance claim against the Contractor?

11.You do not have the right to terminate the rela�onship without liability. For example: If you quit before the job is finished, is there a penalty?

It is a crime to falsify the information on this form.

Effective 1/2/19

Form Breakdown

Fact Detail
Governing Law Administrative Workers' Compensation Act (85A O.S.)
Filing Types Available Original Affidavit of Exempt Status and Renewal
Expiration Expires at midnight two (2) years from the filing date or the expiration date for renewals
Filing Fee $50 nonrefundable, checks not accepted
Eligibility Condition Based on Affidavit Exemption from the definition of “employee” or as an independent contractor to avoid workers’ compensation insurance premiums
Consequences of Submitting False Information Considered a misdemeanor, punishable by a fine not to exceed $1,000.00

Detailed Instructions for Using Oklahoma Exempt

Filing an Oklahoma Exempt Status form is a necessary step for certain individuals or businesses that believe they are not required to secure compensation under the Administrative Workers' Compensation Act (AWCA). This precise process allows you to potentially classify your business in a way that exempts you from the need to provide workers' compensation insurance. But remember, this decision carries significant responsibility and should be approached with careful consideration and understanding of what it entails.

Steps to Fill Out the Oklahoma Exempt Form:
  1. Start by reading the Affidavit of Exempt Status thoroughly to ensure you understand the criteria for being considered exempt under the AWCA.
  2. Type or clearly print your full legal name and the name of your business in the spaces provided at the top of the form.
  3. Check the appropriate box to indicate whether this is an original filing or a renewal. If it's a renewal, you must provide your current Affidavit number and its expiration date.
  4. Complete the section that requests your detailed understanding of an "employee" as defined by 85A O.S. §2(18) and your assertion that your business seeks exemption or is considered that of an independent contractor.
  5. Outline your understanding and agreement that by submitting this Affidavit, you claim your business is exempt and you will not be charged for workers' compensation insurance premiums.
  6. Should your situation change and it becomes necessary to secure compensation pursuant to the AWCA, commit to filing a Cancellation of Affidavit of Exempt Status and securing the necessary insurance.
  7. Confirm that the information provided is accurate and not the result of undue influence by signing the declaration under penalty of perjury.
  8. Include your title, contact phone number, business name, email address, and Federal Employer Identification Number (FEIN/EIN/TIN) in the designated areas.
  9. Record your physical mailing address for official correspondence.
  10. Sign and date the form at the bottom, reaffirming your commitment to honesty and acknowledging the penalties for providing false information.

Once completed, ensure you attach the nonrefundable $50 filing fee payable to the Workers’ Compensation Commission (WCC). You can submit the original and one copy of the form either in person or by mail to the address listed on the form, or you may choose to file online at the official WCC website. Remember, honesty and accuracy are paramount when completing this form to avoid any legal consequences.

FAQ

  1. What is the Oklahoma Affidavit of Exempt Status?

    The Oklahoma Affidavit of Exempt Status is a document that an individual or business can file with the Oklahoma Workers’ Compensation Commission. By submitting this affidavit, you're asking to be considered exempt from being defined as an "employee" or to be recognized as an independent contractor. This means you wouldn't have to pay workers' compensation insurance premiums for the services your business provides. However, it also means you wouldn't be eligible for workers' compensation benefits.

  2. Who can file an Oklahoma Affidavit of Exempt Status?

    Individuals or business entities in Oklahoma that are not required by the Administrative Workers' Compensation Act (AWCA) to secure compensation can file this affidavit. If you are unsure whether you qualify for exempt status, it is recommended that you seek legal advice to understand your specific situation.

  3. How often does the Affidavit of Exempt Status need to be renewed?

    The original Affidavit of Exempt Status expires two years from the filing date. To maintain your exempt status, you must file a renewal before the expiration date. The renewal also lasts for two years. If you currently have an affidavit and are looking to renew it, you must provide the Affidavit number and its expiration date in your renewal request.

  4. What is the filing fee for an Oklahoma Affidavit of Exempt Status?

    A nonrefundable filing fee of $50 is required to file an Affidavit of Exempt Status. This fee must be paid to the Workers' Compensation Commission (WCC). It's important to note that checks are not accepted.

  5. Can you cancel your Affidavit of Exempt Status?

    Yes, if circumstances change and you decide to secure compensation under the AWCA, you can cancel your Affidavit of Exempt Status. This is done by executing and filing a Cancellation of Affidavit of Exempt Status with the Workers' Compensation Commission. Following this, you would need to obtain workers' compensation and employers' liability insurance for your employees unless they are also exempt under the AWCA.

  6. What happens if you provide false information on the Affidavit of Exempt Status?

    Knowingly providing false information on an executed Affidavit of Exempt Status is considered a misdemeanor. This offense can lead to a fine of up to One Thousand Dollars ($1,000.00). Therefore, it is crucial to ensure that all information provided in the affidavit is true, accurate, and complete to the best of your knowledge.

  7. Where can you file the Oklahoma Affidavit of Exempt Status?

    You can file the original and one copy of your affidavit directly with the Oklahoma Workers’ Compensation Commission either in person or by mail. Additionally, the option to file online is available at the official website www.ok.gov/wcc. This provides a convenient way to manage your filing without the need for a physical visit to the commission's office.

Common mistakes

When filling out the Oklahoma Exempt form, individuals often overlook crucial steps or misunderstand instructions, leading to errors that can impact their exempt status. Here are nine common mistakes:
  1. Not including the filing fee: Applicants sometimes forget to include the nonrefundable $50 filing fee, which is mandatory with the application. Remember, checks are not accepted.

  2. Choosing the wrong type of filing: It's critical to accurately indicate whether the affidavit is an original application or a renewal. A simple oversight here can lead to processing delays.

  3. Omitting the Exempt Status Fact Sheet: Failing to read, sign, and attach the Exempt Status Fact Sheet is a common mistake. This sheet is essential for understanding definitions and exceptions relevant to your status.

  4. Incorrect business identification: Applicants often provide incorrect or incomplete business names or fail to include their FEIN/EIN/TIN, which is crucial for identification.

  5. Neglecting contact information: Not providing a current phone number or email address can lead to communication issues, stalling the process.

  6. Incomplete address details: Failing to provide a complete mailing address may result in important correspondences being lost or delayed.

  7. Signing inaccuracies: The affidavit requires a signature to verify that the information provided is true and accurate under penalty of perjury. Sometimes, this section is left unsigned or is signed by an unauthorized individual.

  8. Overlooking the renewal date: For renewals, not including the current Affidavit number and its expiration date can lead to unnecessary complications.

  9. Misunderstanding independent contractor status: Many applicants incorrectly assume their status as independent contractors without carefully evaluating the specific criteria that distinguish an independent contractor from an employee.

To avoid these mistakes, it's important for individuals to review the form carefully, ensure all required information and documentation are included, and understand the definitions and qualifications pertaining to their employment status. Seeking legal advice can also help clarify any uncertainties and ensure compliance with the Administrative Workers' Compensation Act.

Documents used along the form

When working with the Oklahoma Exempt form, it's crucial to understand its role within the broader context of business documentation, especially for those navigating the complexities of independent contractor status or seeking exemption from the Administrative Workers' Compensation Act. Alongside this form, there are several other important documents and forms that might be necessary depending on specific business needs, regulatory requirements, or during periodic assessments of contractor relationships.

  • Notice of Independent Contractor Status: This document is often used by individuals or entities to declare their status as independent contractors, thereby acknowledging their understanding and acceptance of the responsibilities and risks associated with this status, including the lack of traditional employment benefits.
  • Workers’ Compensation Waiver: In certain jurisdictions, independent contractors might have the option to waive their rights to workers’ compensation benefits, underlining the distinction from regular employees who typically cannot opt out of these protections.
  • General Liability Insurance Policy: A critical document for both independent contractors and businesses, this insurance policy provides broad coverage for claims of bodily injury, property damage, and more, crucial for mitigating financial risks arising from accidents or negligence.
  • Professional Liability Insurance Policy: Especially relevant for contractors offering professional services, this document outlines coverage for claims related to errors, omissions, or professional negligence, protecting personal and business finances against lawsuits.
  • Contract for Services: An essential agreement between an independent contractor and their client detailing the scope of work, payment terms, timelines, and other conditions of the service relationship, ensuring clarity and mutual understanding.
  • IRS Form W-9: Used by businesses to gather information from contractors for tax reporting purposes; it's an important part of managing financial and tax obligations related to payments made to non-employees.
  • IRS Form 1099-MISC: A critical tax document for the reporting of payments made to independent contractors, ensuring compliance with tax laws by distinguishing these payments from traditional wages.
  • Business Registration and Licensing Documents: Depending on locality and industry, independent contractors and businesses may need various registrations or licenses to legally operate, underscoring the formality and legitimacy of their operations.

Understanding and properly managing these documents can help ensure clarity in the responsibilities and rights of independent contractors, providing a foundation for healthy business relationships and compliance with applicable laws and regulations. Importantly, the specific requirements and applicable documents can vary widely based on jurisdiction, industry, and the nature of the work performed, making it paramount for businesses and contractors alike to stay informed and seek appropriate advice when necessary.

Similar forms

The Oklahoma Exempt Form shares similarities with the Application for Independent Contractor Exemption (ICE) used in various states to establish a worker’s status as an independent contractor rather than an employee. This application, like the Oklahoma Exempt Form, requires detailed information about the nature of the business, the relationship with clients, and the degree of control exercised over the work performed. Both forms involve a self-certification process where the applicant must declare their business operations and worker relationships, underscoring their understanding and compliance with specific labor laws and exemptions.

Another document similar to the Oklahoma Exempt Form is the Certificate of Non-Coverage (CNC), commonly used in the construction industry. This certificate serves as proof that an individual is not covered under a workers' compensation policy because they are either a business owner or independent contractor. Both the CNC and the Oklahoma Exempt Form require the individual to provide detailed personal and business information, acknowledge their exemption status, and understand the implications, including the forfeiture of workers' compensation benefits.

The Request for Determination of Independent Contractor Status (RDICS) also mirrors the Oklahoma Exempt Form in significant ways. Used to establish a worker's status for tax and employment purposes, the RDICS involves a detailed examination of the working relationship, control over work, and financial aspects of the job. Similar to the Oklahoma document, filing a RDICS requires a clear assertion of independence from traditional employee status, affecting tax liabilities and eligibility for benefits.

The Self-Employment Affidavit is another document bearing resemblance to the Oklahoma Exempt Form. It is often used by individuals to declare their status as self-employed or as an independent contractor for various compliance and regulatory purposes, including tax filings and benefit claims. Like the Oklahoma Exempt Form, the Self-Employment Affidavit necessitates a declaration of the nature of the work, the business structure, and an acknowledgment of the responsibilities and rights that come with self-employed status.

Lastly, the Declaration of Independent Business Status (DIBS) is similar to the Oklahoma Exempt Form in its purpose and the information it collects. This document is typically used by businesses and individuals to officially declare their status as independent entities, distinct from employees of another business. Both the DIBS and the Oklahoma Exempt Form require the declaration of operational independence, a description of the services provided, and acknowledgment of the legal implications of such a status, particularly regarding workers' compensation and employment laws.

Dos and Don'ts

Completing the Oklahoma Exempt form requires attention to detail and a clear understanding of your status as it pertains to workers' compensation laws. Here's a guide on what you should and shouldn't do when filling out this crucial document.

Do:

  1. Read the Exempt Status Fact Sheet thoroughly to understand the criteria for being considered an independent contractor versus an employee.

  2. Ensure all information provided on the form is true and accurate to the best of your knowledge, acknowledging that false representation is a punishable offense.

  3. Check whether you are filing an original affidavit or renewing an existing one, and mark the appropriate option.

  4. Include your business name and personal information exactly as they appear in official documents to avoid discrepancies.

  5. Sign the affidavit under penalty of perjury, confirming the accuracy and completeness of the information provided.

Don't:

  • Don't overlook the importance of attaching the required Exempt Status Fact Sheet after fully understanding its contents.

  • Don't attempt to file the form without the nonrefundable $50 filing fee, remembering that checks are not accepted.

  • Don't ignore the renewal expiration date if you're filing a renewal application. Ensure it's correctly noted.

  • Don't falsify any information on the affidavit. Knowingly doing so is a misdemeanor with serious consequences.

  • Don't forget to review the conditions under which you may need to cancel your exempt status, particularly if your business circumstances change.

Adhering to these recommendations can help ensure that the process of claiming exempt status under the Administrative Workers' Compensation Act in Oklahoma is smooth and compliant with state requirements. Remember, when in doubt or for complex situations, seeking legal counsel is advisable to clarify your status and obligations.

Misconceptions

There are several misconceptions about the Oklahoma Exempt Status Form, often arising due to its detailed requirements and the legal language it employs. Here's a clearer look at some of those misunderstandings:

  • Filing Fee Is Negotiable: The document clearly states a nonrefundable $50 filing fee must accompany the form. This fee is fixed and non-negotiable, contrary to the belief that it can be waived or reduced.
  • Digital Signature Is Accepted: The form requires an original signature. This means a handwritten signature is necessary; a digital or electronic signature would not fulfill this requirement.
  • Renewals Are Automatic: Some think once you file an original affidavit, renewals happen automatically. However, the form mentions that for a renewal, an affidavit number and expiration date must be provided, indicating that the individual must initiate the renewal process.
  • Exemption Applies to All Business Entities: The document specifies that the affidavit can apply to an individual or a business entity, leading some to wrongly assume all types of entities qualify. The truth is, eligibility for exempt status is based on specific criteria, not all entities will qualify.
  • Exempt Status Prevents All Workers' Compensation Claims: While the form does state that executing the affidavit establishes a presumption of exemption, this does not mean an absolute shield against all potential claims. Certain circumstances might still lead to liability, especially if there is a misrepresentation of facts.
  • Independent Contractors Cannot Be Employees: A common misconception is that independent contractors are universally considered non-employees. However, the exempt status fact sheet outlines criteria that determine independent contractor status, suggesting that the distinction is not always clear-cut.
  • Submission Guarantees Approval: Submitting the affidavit does not automatically result in exempt status. The Workers’ Compensation Commission reviews each submission for compliance and accuracy, maintaining the right to reject applications that do not meet requirements.
  • Falsification Penalties Are Limited to Fines: While the document indicates a misdemeanour punishable by a fine not to exceed $1000, it also notes that any form of workers’ compensation fraud can lead to felony charges, which could include imprisonment, fines, or both.

Understanding the Oklahoma Exempt Status Form correctly is critical for businesses and individuals aiming to navigate workers' compensation requirements effectively. Clearing up these misconceptions is a step toward ensuring compliance and avoiding potential legal pitfalls.

Key takeaways

Filling out and using the Oklahoma Exempt form, officially titled Affidavit of Exempt Status under the Administrative Workers' Compensation Act, requires attention to detail and an understanding of your business status. Here are key takeaways to guide you through the process:

  • Eligibility for filing: Individuals or businesses believing they are not required to secure compensation under the Administrative Workers’ Compensation Act (AWCA) may file.
  • Online and offline filing: The form can be filed in person, by mail, or online at the official website, providing flexibility for applicants.
  • Nonrefundable filing fee: A $50 filing fee, which is nonrefundable, must accompany the form, underscoring the need for careful completion.
  • Understanding worker classification: Proper understanding of the definition of "employee" and "independent contractor" as per AWCA is crucial before filing.
  • Importance of accuracy: Information provided must be accurate to avoid potential misdemeanor charges, emphasizing the seriousness of the affidavit.
  • Renewal requirements: The affidavit expires two years from the filing date, necessitating timely renewal for ongoing exemption.
  • Change in circumstances: Filers must commit to securing necessary workers’ compensation upon any change that invalidates their exempt status.
  • Impact on employees: The exemption does not affect the rights or coverage of the entity’s employees, ensuring their protection remains intact.
  • Financial implications for wrongful claims: Misrepresentations leading to workers’ compensation payouts by contractors can result in financial recovery actions against the affiant.
  • Legal consequences of misinformation: Knowingly falsifying the affidavit is a misdemeanor, punishable by a fine, highlighting the legal implications of dishonesty.
  • Exempt Status Fact Sheet: Referring to the attached Exempt Status Fact Sheet for clarity on independent contractor status can guide the decision to file.

By considering these aspects carefully, individuals and businesses can navigate the process of declaring exempt status in Oklahoma more effectively, ensuring compliance with state requirements while recognizing their rights and obligations under the AWCA.

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