Instructions on How to Fill out Worker’s Compensation Election Form

You can fill out sections either “A” or “B” depending on your status and sign and fill out section “D” called certification.

If you are a part of a Corporation or a Limited Liability Company, then fill out Sections “A” and Section “D”.

If you are a Sole Proprietor or a Partner in an Limited Liability Company, then fill out Section “B” and Section”D”.