NOTE: THIS FORM APPLIES ONLY TO STATE OF ARIZONA AGENCIES, BOARDS,. COMMISSIONS, AND UNIVERSITIES UTILIZING SOLE PROPRIETORS WITH NO EMPLOYEES. IF YOU ARE ...

SOLE PROPRIETOR WAIVER. The following is a written waiver under the compulsory workers' compensation laws of the. State of Arizona, A.R.S 23-901 (et seq.), ...

Sole Proprietor Waiver. To submit this form click here. Document Type. Insurance Forms · Sole Proprietor Waiver.pdf. Official Seal of the State of Arizona ...

ARIZONA SOLE PROPRIETOR WAIVER. Note: This form applies only in Arizona and to CopperPoint policyholders utilizing Sole Proprietors with no employees and.

NOTE: THIS FORM APPLIES ONLY TO STATE OF ARIZONA AGENCIES, BOARDS,. COMMISSIONS, AND UNIVERSITIES UTILIZING SOLE PROPRIETORS WITH NO EMPLOYEES. IF YOU ARE ...

SOLE PROPRIETOR WAIVER/SINGLE MEMBER LLC WAIVER. NOTE: THIS FORM APPLIES ONLY TO SCF ARIZONA POLICYHOLDERS UTILIZING SOLE PROPRIETORS OR SINGLE MEMBER LLC.

This form is for use only by a sole proprietor who is working for an employer who has workers' compensation insurance as permitted by ARS §23-961(P).

Proprietor may waive his/her rights to Workers' Compensation coverage and benefits. I am a sole proprietor/independent contractor and I am doing business as:.

How do I fill this out? To fill out this form, provide your business details, sign the waiver, and submit it to the relevant state agency.

FSL Home Improvements. 1201 E Thomas Rd. Phoenix, AZ 85014. Phone: (602) 532-2976. Fax: (602) 297-1857. Sole Proprietor Waiver. Pursuant to A.R.S. 23-961, ...