Commonly Used Forms available for printing and mailing to the Workers' Compensation Board.
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Filed with any entity requesting to be a certificate holder including a government agency issuing a permit, license or contract. The C-105.2 must be completed ...
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Find resources and reporting requirements related to workers' compensation, disability and Paid Family Leave insurance coverage. eClaims · Proof of Coverage ...
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Commonly Used Injured Worker Forms available for printing and mailing to the Workers' Compensation Board.
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Only two types of entities may apply for a certificate to show they are exempt from the requirement to provide workers' compensation and/or disability and Paid ...
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Employers must obtain this form from their insurance carrier or licensed agent. C-105.2 (9/15), Certificate of NYS Workers' Compensation Insurance Coverage (All ...
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Completing Forms. If you require assistance with completing these forms, please contact us. Forms are in PDF format. The Board recommends using the latest ...
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Fill out this form to apply for workers' compensation benefits because of a work injury or work-related illness. Required items are indicated by an *.
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