Form Exemption Compensation Form Details

Form 13L 50 is an informational return that must be filed with the IRS by partnerships that make distributions in excess of their current and accumulated earnings and profits. The form helps ensure that the tax liability for these distributions is allocated fairly among the partners. In order to complete Form 13L 50, you will need to know the partnership's adjusted basis in its assets and liabilities, as well as its earnings and profits. You can find more information about Form 13L 50 in this article.

You will discover more details in regards to the form 13l 50 by checking out the table we put together.

QuestionAnswer
Form NameForm 13L 50
Form Length1 pages
Fillable?Yes
Fillable fields19
Avg. time to fill out4 min 7 sec
Other namesca exemption workers compensation, workers compensation form 13l 50, exemption form 13l 50, 13l 50 form

Form Preview Example

CONTRACTORS STATE LICENSE BOARD

STATE OF CALIFORNIA

9821 Business Park Drive, Sacramento, California 95827

Governor Edmund G. Brown Jr.

Mailing Address: P.O. Box 26000, Sacramento, CA 95826

 

800-321-CSLB (2752)

 

www.cslb.ca.gov CheckTheLicenseFirst.com

 

Exemption from Workers’ Compensation

Before the Contractors State License Board (CSLB) can issue a new license or reinstate, reactivate, or renew an existing license, the applicant or licensee must have on file a Certificate of Workers’ Compensation Insurance or a Certificate of Self-Insurance issued by the Director of Industrial Relations, or must obtain an exemption by completing and submitting this form.

To be exempt from workers’ compensation, an applicant or licensee must submit this form to CSLB, certifying under penalty of perjury that he or she does not employ anyone in a manner that is subject to the workers’ compensation laws of California. (See Business and Professions Code Section 7125.)

DO NOT SUBMIT THIS FORM IF:

You have an inactive license.

The license qualifier is a Responsible Managing Employee (RME).

You hold a C-39 Roofing classification – all contractors with a C-39 Roofing classification are required by Section 7125 to have a Certificate of Workers’ Compensation Insurance or a Certificate of Self-Insurance on file with the Board. Contractors with a C-39

Roofing classification are not eligible for exemption from workers’ compensation.

You have employees.

For exemption from workers’ compensation, complete all of the requested information in Section 1, check only one of the boxes in Section 2, and date and sign the form in Section 3.

Please type or print neatly and legibly in black or dark blue ink.

SECTION 1 REQUIRED BUSINESS NAME AND ADDRESS

Business Name (as it currently appears on CSLB records)

 

 

 

 

License or Application Fee Number

 

 

 

 

 

 

 

 

Business Mailing Address (number/street or P.O. box)

 

City

 

State

Zip Code

 

 

 

 

 

 

 

Business Street Address (number/street only – NO P.O. boxes)

City

 

State

Zip Code

 

 

 

 

 

 

Business Phone Number

Business Fax Number

 

 

Business E-mail Address

 

(

)

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check this box if the address shown above is new. CSLB will update your license / application business address of record.

SECTION 2 REQUIRED CHECK BOX

YOU MUST CHECK ONLY ONE OF THE BOXES BELOW.

I do not employ anyone in the manner subject to the workers’ compensation laws of California. OR

I am an out-of-state contractor, and I do not hire employees who reside in California. (You must provide a certificate of insurance from your workers’ compensation insurance carrier in your home state.)

SECTION 3 REQUIRED SIGNATURE

I certify under penalty of perjury under the laws of the State of California that the information provided on this exemption statement is true and accurate. I understand that, upon employing anyone in a manner that is subject to the workers’ compensation laws of the State of California, the claim of exemption executed under this form will no longer be valid. I also understand that, as soon as I employ anyone subject to the California’s workers’ compensation laws, I must obtain a Certificate of Workers’ Compensation Insurance, submit that certificate to CSLB within 90 days of its effective date, and continuously maintain the coverage provided by the certificate in accordance with the law. I further understand that failure to comply with this requirement is grounds for disciplinary action. (The definition of “perjury” is telling a lie while under oath.)

FALSIFICATION OF ANY DOCUMENT IS GROUNDS FOR DISCIPLINARY ACTION.

Date

Signature of Contractor (Owner, Partner, or Officer)

Printed Name of Contractor (Owner, Partner, or Officer)

NOTICE ON COLLECTION OF PERSONAL INFORMATION

CSLB collects the personal information requested on this form as authorized by Business and Professions Code Section 30. CSLB uses this information to identify and evaluate applicants for licensure, issue and renew licenses, and enforce licensing standards set by law and egulation. Submission of the requested information is mandatory. CSLB cannot consider this Exemption from Workers Compensation form unless you provide all of the requested information. You may review the records maintained by CSLB that contain your personal information, as permitted by the Information Practices Act. CSLB makes every effort to protect the personal information you provide us; however, it may be disclosed in response to a Public Records Act request as allowed by the Information Practices Act; to another government agency as required by state or federal law; or in response to a court or administrative order, a subpoena, or a search warrant. This application contains an applicant authorization for the Franchise Tax Board to disclose to CSLB any outstanding final liabilities for the purpose of administering Business and Professions Code Section 7145.5. For more information on the Information Practices Act, visit the Office of Privacy Protection’s website at www.privacy.ca.gov.

FOR CSLB USE ONLY

*WC-EXEMPT*

13L-50 (rev. 4/11)

How to Edit Form 13L 50

Writing the exemption compensation print document is simple using our PDF editor. Follow these particular steps to get the document ready straight away.

Step 1: Seek out the button "Get Form Here" and then click it.

Step 2: Now it's easy to change the exemption compensation print. Our multifunctional toolbar will allow you to include, delete, improve, and highlight content as well as conduct other sorts of commands.

Fill in the exemption compensation print PDF and enter the material for each section:

workers exemption fields to complete

Type in the information in the Date, Signature of Contractor (Owner, Printed Name of Contractor (Owner, FOR CSLB USE ONLY, NOTICE ON COLLECTION OF PERSONAL, 13L-50 (rev, and EXEMPT * area.

Filling in workers exemption step 2

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