California Workers Compensation Exemption Form
This form allows employers to report an injury or illness to their carrier and or the ca department of insurance. Exemption from workers compensation out of state contractors. Application For Consent To Transfer Securities Pursuant To Section 25151 Dbo 260 151 A California Corporate Security California State To be exempt from workers compensation an applicant or licensee must submit this form to cslb certifying under penalty of perjury that he or she does not employ anyone in a manner that is subject to the workers compensation laws of california. California workers compensation exemption form . Report of suspected medical care provider fraud. To be exempt from workers compensation an applicant or licensee must submit this form to cslb certifying under penalty of pe rjury that he or she does not employ anyone in a manner that is subject to the workers compensation laws of california. I also understand that as soon as i employ anyone subject to the california s workers. The