Exemption from Workers' Compensation Insurance

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    Online Submission

    You cannot be exempt from Workers' Compensation if: the qualifier is a Responsible Managing Employee (RME); if you hold a C-8 Concrete classification, C-20 Warm-Air Heating, Ventilating and Air-Conditioning classification, C-22 Asbestos Abatement classification, C-39 Roofing classification, and/or C-61/D-49 Tree Service classification ; or if you have employees (including Home Improvement Salespersons (HIS). Joint Venture entities are excluded from this provision.

    If you are an out-of-state contractor licensed in California, but you have employees working in California from another state, you must also provide a certificate of insurance from your workers' compensation insurance carrier in your state in addition to submitting the exemption. You can fill out the Exemption form using this process; however, you cannot submit the document through the online portal. When prompted you will need to print, email, or save the document to your own device. Please submit exemption and your out-of-state insurance certificate by email to workerscomp@cslb.ca.gov or by mail to CSLB.

    This Online Submission process walks you through the required fields for an Exemption from Workers' Compensation Insurance. This process was established to assist Licensees and Applicants with a way to submit an Exemption from Workers' Compensation Insurance with no exclusion errors. This information can only be added by an Owner, Partner, Officer, Director, Member, or Manager.

    Once you have completed the online submission, the information will automatically update the CSLB database. Do not send any copies to CSLB. If you provided an email, a "For your Records" copy will be sent to that email address.


    IMPORTANT INFORMATION:

    Be sure to use the "Back" and "Next" buttons at the bottom of each page - DO NOT use your browser's back arrow because all of your entered information will be erased and you will have to start over.

    Please type your information directly into the fields of this form. If you copy text from another application or document and paste it into this Easy-Fill form and the text contains invalid (non-ASCII) characters, they will be removed from the final document.

    Make sure you give yourself enough time to complete the entire form in one sitting. You will not be able to save a partially filled form to complete at a later time.

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    General Information and Instructions

    This is an interactive process. You will not be permitted to continue if required fields are incomplete.

    Make sure you give yourself enough time to complete the entire form in one sitting. You will not be able to save a partially filled form to complete at a later time.

    You are not eligible for Exemption if:

    • You have employees, including Home Improvement Salespersons (HIS) or a qualifier who is a Responsible Managing Employee (RME).
    • You hold a C-8 Concrete classification, C-20 Warm-Air Heating, Ventilating and Air-Conditioning classification, C-22 Asbestos Abatement classification, C-39 Roofing classification, and/or C-61/D-49 Tree Service classification - all contractors with a C-8 Concrete classification, C-20 Warm-Air Heating, Ventilating and Air-Conditioning classification, C-22 Asbestos Abatement classification, C-39 Roofing classification, and/or C-61/D-49 Tree Service classification are required by B&P Section 7125 to have a Certificate of Workers' Compensation Insurance or a Certificate of Self-Insurance on file with CSLB. Joint Venture entities are excluded from this provision.

    Do not continue this process if you cannot certify that you are an Owner, Partner, Officer, Director, Member, or Manager on the license or application.

    You will have a chance to review the information entered in its entirety before submission. Once you agree to the contents, you will be given the option to submit the information to CSLB or save/print the document to your own device for submission through email to workerscomp@cslb.ca.gov or by mail.

    If you print the exemption form a signature is required or the document will be returned for correction by CSLB.

    If you employ persons in connection with your California contractor's license in a manner that invokes the workers' compensation laws of your home-state, the exemption information cannot be submitted online. The exemption must be printed and emailed with your home-state insurance certificate to workerscomp@cslb.ca.gov or mailed to CSLB. The exemption form must be signed and your home-state certificate insurance must be attached.

    The form will no longer be available to edit or save once it has been submitted.

    Submitting this document WILL update the license or application record. Please be sure that the information provided is true and accurate.

    Once the information is submitted to the CSLB, do not mail, fax or email additional copies. Copies received with the same information will cause a delay in processing.

    Information and final instructions will be provided upon completion of the Easy-Fill form.


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    Required Information

    Select the appropriate response for each statement below:

    1. The qualifier for this license is a Responsible Managing Employee (RME).
    2. This license/application has a C-8 Concrete classification, C-20 Warm-Air Heating, Ventilating and Air-Conditioning classification, C-22 Asbestos Abatement classification, C-39 Roofing classification, and/or C-61/D-49 Tree Service Classification.
    3. I have employees, (including any Home Improvement Salespersons (HIS)).
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    Disclaimer

    Select the statement that is true:




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    Review and Edit

    Please Review the Following Information

    This is a summary of what will print on your form. If there are any corrections that need to be made, please choose the Edit buttons to the right or Back Button on the bottom left to make the change now, as you will not have the opportunity to do so after you submit this page.


    Reminder: Do Not use the browser's back and forward arrows.

    Penalty of Perjury

    Agree To Complete


    • You will no longer be able to make changes
    • The information entered on this form will NOT be added to the CSLB database
    • You will be directed to “Completion Instructions” where you will be able to review, print or save the PDF to your own device for submitting through email to workerscomp@cslb.ca.gov or by mail

    If you need to make any corrections to the provided information, please choose the Back or Edit buttons.
    If you do not wish to continue this process, please select the Cancel button to return to CSLB’s Home Page.

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    Completion Instructions

    Exemption has been Submitted

    DO NOT SEND this data in a different format, either by mail, email or fax, as this may cause delays with information previously submitted.

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