No-employees declaration.

For sole proprietors who work alone and do not carry workers' compensation insurance. Fill it in, sign on screen, and save the PDF. Then upload the PDF in step 4 of your vendor registration.

Licensed contractors: use the CSLB's own exemption form instead. Corporations, partnerships and businesses with more than one owner: call (866) 830-4401.

About you

Your full legal nameBusiness nameLeave blank if you work under your own name.Business street addressCity, state and ZIP codeMobile phoneEmailWork you do on Access work ordersFor example: house cleaning, yard care, minor repairs.

Declaration of no employees

To: Access Asset Management, Inc.

I, , declare:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Sign

City where you are signingState

Today's date and the time are added when you press Sign.

I have read the whole declaration above.I agree to sign this declaration electronically and to receive my copy electronically. My typed name and my drawn signature are my signature, with the same legal effect as ink on paper. I can ask Access for a paper copy at (866) 830-4401.Type your full legal name to signMust match the name at the top.

Draw your signature

Form AAM-NE-1, version 2026-11-10. Access Asset Management, Inc. · California DRE #01870371 · (866) 830-4401

No-employees declaration.

Declaration of no employees

Signed.