NY DB-820.1 2018-2025 free printable template
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STATE OF NEW YORK WORKERS\' COMPENSATION BOARD
DISABILITY AND PAID FAMILY LEAVE BENEFITS SUPPLEMENT TO CERTIFICATE OF INSURANCE
WEB Plan #Employer FEINT his supplement is attached to and made a part
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How to fill out new york supplement certificate
How to fill out NY DB-820.1
01
Obtain the form NY DB-820.1 from the New York State Department of Labor website or your employer.
02
Enter your personal information in the specified fields, including your name, address, and Social Security number.
03
Provide details about your employment history, including the names of employers and dates of employment.
04
If applicable, indicate any additional income sources or benefits you are receiving.
05
Review the form for accuracy and completeness to ensure all required fields are filled out.
06
Sign and date the form at the bottom.
07
Submit the completed form to the appropriate New York State agency by mail or in person.
Who needs NY DB-820.1?
01
Individuals who are applying for unemployment benefits in New York State are required to fill out NY DB-820.1.
02
Workers who have been laid off, discharged, or have reduced hours may need to complete this form to provide necessary employment details.
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What is NY DB-820.1?
NY DB-820.1 is a form used in New York for reporting and documenting certain employer-related information regarding disability benefits.
Who is required to file NY DB-820.1?
Employers in New York who provide disability benefits to their employees are required to file NY DB-820.1.
How to fill out NY DB-820.1?
To fill out NY DB-820.1, employers must complete the necessary sections of the form with accurate information regarding their business and disability benefits provided, then submit it according to the guidelines set by the New York State Workers' Compensation Board.
What is the purpose of NY DB-820.1?
The purpose of NY DB-820.1 is to ensure compliance with New York State laws regarding disability benefits and to provide necessary information to support the administration of these benefits.
What information must be reported on NY DB-820.1?
NY DB-820.1 must report information such as the employer's details, type of disability benefits provided, duration of benefits, and other related employee information.
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