Florida workers compensation exemption affidavit

The Division of Workers' Compensation offers an online system for applicants to apply for or renew a Certificate of Election to be Exempt from Florida's Workers' Compensation Law, modify an exemption application, or print their certificate.

If at any time you need assistance with the DWC Notice of Election to be Exempt system, you may contact the Division's Customer Service Unit at (850) 413-1609 or email at wc_exemption@myfloridacfo.com.

A VALID state driver’s license is required to obtain or renew a Certificate of Election to be Exempt. A driver license is considered valid provided it has not been expired for more than 30 days at the time of submission of the exemption application. If an application is returned for any reason, the original exemption application submission date will apply when determining if a license is valid.

Eligibility Information

Corporation:

• The corporation must be registered and listed as active with the Florida Department of State, Division of Corporations.
• The applicant must be listed as an officer of the corporation in the records of the Florida Department of State.
• The applicant must attest to a minimum 10 percent ownership of the corporation.
• No more than three officers of a corporation or of any group of affiliated corporations (including LLCs) may elect to be exempt.
• A $50.00 application fee is required.
• Applicant cannot be affiliated with an ACTIVE Stop Work Order (SWO) or Working in Violation (WIV).
• An applicant associated with a payment that is insufficient is not eligible for an exemption.

Limited Liability Company (LLC):

• The LLC must be registered and listed as active with the Florida Department of State, Division of Corporations.
• The applicant must attest to a minimum 10 percent ownership of the LLC.
• No more than three officers of an LLC or of any group of affiliated LLCs (including corporations) may elect to be exempt.
• A $50.00 application fee is required.
• Applicant cannot be affiliated with an ACTIVE Stop Work Order (SWO) or Working in Violation (WIV).
• An applicant associated with a payment that is insufficient is not eligible for an exemption.