NY DB-212.5 2017-2025 free printable template
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STATE OF NEW YORK WORKERS\' COMPENSATION BOARDS AGENCY EMPLOYS AND SERVES PEOPLE WITH DISABILITIES WITHOUT DISCRIMINATION.NOTICE OF ELECTION TO VOLUNTARILY EXCLUDE SPOUSE FROM COVERAGE PURSUANT TO
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How to fill out NY DB-212.5
01
Obtain a copy of the NY DB-212.5 form from the New York State Department of Labor website.
02
Read the instructions carefully to understand the purpose of the form.
03
Fill in your personal information at the top of the form, including your name, address, and contact information.
04
Provide details about your employer, such as their name and address.
05
Describe the incident that led to the need for the form, including dates, locations, and any relevant details.
06
Indicate the type of claim you are filing (e.g., unemployment, workers' compensation).
07
Attach any supporting documentation that may be required, such as medical records or wage statements.
08
Review the entire form for accuracy and completeness before signing.
09
Submit the form according to the instructions provided (mail, online submission, etc.).
Who needs NY DB-212.5?
01
Individuals who have experienced a workplace injury or illness.
02
Employees seeking to file a claim for compensation or benefits.
03
Workers who need to document their employment status for legal purposes.
04
People seeking unemployment benefits related to their job loss.
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What is NY DB-212.5?
NY DB-212.5 is a form used in New York State for reporting certain business employee-related expenditures or adjustments for unemployment insurance purposes.
Who is required to file NY DB-212.5?
Employers in New York State who have paid wages to employees and need to adjust their UI contributions or report employee-related expenditures are required to file NY DB-212.5.
How to fill out NY DB-212.5?
To fill out NY DB-212.5, employers should provide their business information, the specific details of employee-related expenditures or adjustments, and ensure all required fields are accurately completed before submission.
What is the purpose of NY DB-212.5?
The purpose of NY DB-212.5 is to facilitate accurate reporting of employee-related expenditures and ensure proper calculations of unemployment insurance contributions by employers.
What information must be reported on NY DB-212.5?
The information that must be reported on NY DB-212.5 includes employer identification details, employee wages, expenditures or adjustments related to unemployment insurance, and any supporting documentation required by New York State.
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