DWC 250 Notice of Election to Be Exempt

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DWC 250 Notice of Election to Be Exempt

In Florida, certain employees receive compensation under the local workers’ compensation laws (Chapter 440, Title XXXI, the Florida Statutes). Such compensation includes, for instance, insurance coverage in case of traumas an employee gets in a workplace while performing their duties.

Specific employers can avoid obeying compensation laws on certain conditions. It relates to officers who represent corporations and to members of companies with limited liability. Both individuals and entities should be registered in Florida.

To apply, officers and members must check the rules on the Division of Workers’ Compensation webpage. There is a long list of rules, and your possibility to claim varies on the sphere you work in and other factors.

If you check all the rules and find yourself eligible to claim exemption, you have to submit the DWC 250 Notice of Election to be Exempt. If your application is accepted, you are not considered an employee anymore. They shall not recover compensation perks that employees receive.

How to Fill Out the Template

The template is not that difficult to fill out; filers should outline all the required data on just two sheets. You will specify your title in a corporation or company with limited liability, insert your name and contact info, find out about the documents you need to attach to the notice, and sign the document to verify all the written items.

Highly likely, you will not need any help from specialists to create this form. Even so, we provide a brief set of guidelines here.

Get the Template

The first thing you almost always need to do when you create any document is to find its right template. We provide you with our smart form-building software. Its main purpose is to generate various legal templates, and the DWC 250 Notice of Election to be Exempt is available here, too.

Use our software to get the form easily and move to the following step.

Identify Yourself

In Section 1, you should write your full legal name, social security number (SSN), and valid email address. It is optional, but you had better leave it because this address will be used by the Division to notify you about your case.

step 2 - identify yourself - filling out dwc 250 notice of election to be exempt

Choose Why You Are Applying

Next, you will see three options explaining why you can apply for an election. You should pick only one option here and insert your title in the organization you represent.

step 3 - choose why you are applying - filling out dwc 250 notice of election to be exempt

Write Your Entity’s Registration Number

If you want to claim such an election in Florida, the corporation or company you represent must be registered in the Division of Corporations (Florida Department of State). Insert the number of your organization’s registration document in Section 3.

step 4 - write your entity’s registration number - filling out dwc 250 notice of election to be exempt

Tell More about the Organization and Yourself

Section 4 requires adding the organization’s name and FEIN (federal employer identification number). Enter the business name and phone number. Insert the entity’s full address where you can receive mail and determine the scope of business below.

step 5 - tell more about the organization and yourself - filling out dwc 250 notice of election to be exempt

Add Info about Licenses

You should list the registered or certified licenses described in Section 5. If there are no licenses, leave the section blank.

step 6 - add info about licenses - filling out dwc 250 notice of election to be exempt

Insert Transaction Confirmation Number

If you have paid any fee related to this notice, and the payment has been made digitally, insert the transaction confirmation number in Section 6.

step 7 - insert transaction confirmation number - filling out dwc 250 notice of election to be exempt

Indicate Other Corporations You Are Affiliated with (If Any)

If you are affiliated with any other corporation besides the one described above, mark the “yes” box and add that corporation’s number and FEIN. You must include details on all such corporations.

step 8 - indicate other corporations you are affiliated with (if any) - filling out dwc 250 notice of election to be exempt

Check the Documents You Must Attach

If applying from certain organizations, you must provide additional documents. Read the text in Section 8 carefully to determine what papers you should prepare. There are only two forms you might need to attach.

Read the Caution and Sign the Form

You will sign the document in Section 9. Here, you will also see caution that warns you about penalties you may face if providing misleading information. Double-check your template and ensure that everything is true and correct. Sign the document then.

step 10 - read the caution and sign the form - filling out dwc 250 notice of election to be exempt

Provide the Carrier’s Name

You have to enter the name of the carrier who covers insurance for your workers. Place the name in Section 10.

step 11 - provide the carrier’s name - filling out dwc 250 notice of election to be exempt

Sign the Papers Again

This template requires you to sign it twice. By the second signature, you verify that everything you have written is correct. Sign the form and write the date of signing in suitable lines.

step 12 - sign the papers again - filling out dwc 250 notice of election to be exempt

Notarize the Form

DWC 250 should be notarized after you sign it. Remember to ask a notary for their signature; otherwise, your form will not be enforceable, and you will probably receive it back.

step 13 - notarize the form - filling out dwc 250 notice of election to be exempt

How to Submit the Document

You can submit your form either online or offline. To submit online, visit the official site of the Division. To file offline, check the address of the closest Division office and bring the form and all additional papers there. In some cases, you will have to pay a fee (50 US dollars).

What Happens Then?

The Division has one month to review your form. Then, the document will have one of three statuses:

  • “Process”

It means that you are eligible to be exempt, and the decision on your case is positive.

  • “Return”

You will get the form back and be asked to provide additional data.

  • “Deny”

Your application will be declined for one of the reasons explained by the Division.

If you get the “Return” status, you will have to re-apply with all the demanded forms. In case of denial, you will need to fix the situation and apply again (if fixing is possible).

Remember that your application is valid for a certain period, and you will have to renew it from time to time. If needed, you can cancel your exemption through the Division office (offline) or site (online). Also, if you have any questions, the Division personnel is always ready to help: check the contact info on the official webpage.