HomeMy WebLinkAboutInsurance Certiications Element 8 2• engaged in axi
manager
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• is free
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MONTANA DEPARTMENT OF LABOR & INDUSTRY
INDEPENDE'91atrelbf %Atla6gR PROGRAM
Department of Labor & Industry
INDEPENDENT CONTRACTOR
EXEMPTION CERTIFICATE
has e
STACY A COLLETTE
2015 TRILLIUM
. ;_ HELEg�u
n
�i est?hliched
w-of a corporation or almanager-off
do by hiring agents over the performance of the perscon's.lu
or
ed'th Depatttt of Labor and Industry su en
ntractor. In reliance on that evidence, the cnt
* ertificate to the pers ed above.
[to to noio d any voluntary eligibility for aluthe rigms aad Done to
and is not $e personally co rIc i- �nsatton to e
x
cate holder is respp ble for apexes relat!WV ormed under the
te officers of corporations at- managers of -
#zqr °iiy�esLtim'
AR unemployment to tnee laves and must xe at he— es to the
0 and Ind jpz
:red corporation or
Ad
onto and in fact,
to conclude the cet
anies are
has
icate holder
�nted this
n Act of
wledged
at
tpt from
On of the
i`
of Title 39,
INDEPENDENT
C O
N
T
R A
C T
O
R
INDEPENDE'91atrelbf %Atla6gR PROGRAM
Department of Labor & Industry
INDEPENDENT CONTRACTOR
EXEMPTION CERTIFICATE
has e
STACY A COLLETTE
2015 TRILLIUM
. ;_ HELEg�u
n
�i est?hliched
w-of a corporation or almanager-off
do by hiring agents over the performance of the perscon's.lu
or
ed'th Depatttt of Labor and Industry su en
ntractor. In reliance on that evidence, the cnt
* ertificate to the pers ed above.
[to to noio d any voluntary eligibility for aluthe rigms aad Done to
and is not $e personally co rIc i- �nsatton to e
x
cate holder is respp ble for apexes relat!WV ormed under the
te officers of corporations at- managers of -
#zqr °iiy�esLtim'
AR unemployment to tnee laves and must xe at he— es to the
0 and Ind jpz
:red corporation or
Ad
onto and in fact,
to conclude the cet
anies are
has
icate holder
�nted this
n Act of
wledged
at
tpt from
On of the
i`
of Title 39,