On October 1, 2011 revisions in the Workers’ Compensation Exemption Registry law went into effect. Our forms have been updated accordingly. After clicking into a WCER form, please refresh your browser (F5) to ensure that you are accessing the most current version of the form.

• Frequently Asked Questions
• Initial Workers' Compensation Exemption Registration Application Form (ss-4523)
• Change Of Address Form (ss-4524)
• Request For Copy Of Registration Notice (ss-4525)
• Applicant Correction Form (ss-4526)
• Initial Workers' Compensation Exemption Registration Application For Reinstatement Form (ss-4527)
• Initial Workers' Compensation Exemption Registration Renewal Form (ss-4528)
• Voluntary Revocation Form (ss-4529)
• Subsequent Workers' Compensation Exemption Registration Application Form (ss-4530)
• Subsequentl Workers' Compensation Exemption Registration Application For Reinstatement Form (ss-4531)
• Subsequent Workers' Compensation Exemption Registration Renewal Form (ss-4532)