Verification of Non-Employment Out of State Employer
This form is essential for employers based out of North Dakota who need to verify non-employment status. It assists in ensuring compliance with North Dakota's workers' compensation laws. Use this file to provide accurate information regarding your business's employment status in North Dakota.
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How do I fill this out?
To fill out this form, carefully provide your business details and relevant ownership information. Ensure all officer, partner, and owner details are accurate. Review the questions regarding North Dakota employment requirements before submission.
How to fill out the Verification of Non-Employment Out of State Employer?
1
Gather all necessary business information regarding ownership and employee details.
2
Complete each section of the form accurately to reflect your business status.
3
Provide information on any project associated with North Dakota.
4
Ensure you understand the requirements for coverage in North Dakota before submitting.
5
Review the form for accuracy before submission.
Who needs the Verification of Non-Employment Out of State Employer?
1
Employers operating out of state but engaging with North Dakota employees.
2
Businesses that require compliance with North Dakota's workers' compensation laws.
3
Organizations seeking to establish a North Dakota project requiring official documentation.
4
Limited Liability Corporations (LLCs) needing to verify non-employment for workers in ND.
5
Companies with potential future hires in North Dakota.
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What are the instructions for submitting this form?
To submit this form, you can fax it to 701-328-3750 or mail it to Workforce Safety & Insurance at PO Box 5585, Bismarck, ND 58506-5585. Alternatively, if available, you may be able to submit it online through the state’s submission portal. Ensure all fields are complete to avoid delays.
What are the important dates for this form in 2024 and 2025?
For 2024, the form should be submitted by April 1 to comply with state regulations. In 2025, aim for the same deadline to ensure continuous compliance. Keep an eye on any updates to the submission dates.
What is the purpose of this form?
The purpose of this form is to ensure that employers outside of North Dakota comply with state laws regarding workers' compensation. It verifies that an employer has no employees within the state or acknowledges intent to comply if employing workers in the future. Accurate completion helps prevent legal repercussions for non-compliance.
Tell me about this form and its components and fields line-by-line.
- 1. SSN: Social Security Number of the business owner or main contact.
- 2. Business Name: Name of the business as registered in North Dakota.
- 3. Type of Ownership: Indicates the legal structure of the business.
- 4. Business Address: Physical address where the business operates.
- 5. Telephone: Primary contact number for the business.
- 6. Fax: Fax number for business communications.
- 7. Notary Public: Field for notary verification of the document.
What happens if I fail to submit this form?
Failure to submit this form may result in legal penalties for non-compliance with North Dakota workers' compensation laws. Employers may face fines or other legal action if they engage employees without proper coverage.
- Legal Penalties: Non-compliance could lead to significant fines and legal action against the business.
- Coverage Issues: Absence of verified coverage may complicate claims and lead to financial loss.
- Reputation Damage: Failure to comply may harm the business's reputation within the industry.
How do I know when to use this form?
- 1. Hiring in North Dakota: When planning to hire employees in North Dakota.
- 2. Compliance Checks: To verify non-employment status for compliance audits.
- 3. Business Operations Planning: For businesses establishing a project in North Dakota.
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Can I use this form for out-of-state employees?
Yes, this form is specifically for businesses looking to verify the non-employment status of out-of-state employees.
Do I need any specific information to fill out the form?
You will need your business's federal ID, ownership details, and information about any officers or partners.
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