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TDA 496ELFLW (Rev. 4/10) WE SUBCONTRACTOR REQUEST FOR WAIVER FORM INSTRUCTIONS: SEE PAGE 2 OF THIS ATTACHMENT FOR REQUIREMENTS AND DOCUMENT SUBMISSION INSTRUCTIONS. Offer or/Contractor Name: Federal
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OTDA-4969 ELW is a form used by the New York State Office of Temporary and Disability Assistance (OTDA) to report certain information related to employment and income.
Employers in New York State are required to file OTDA-4969 ELW when requested by the OTDA.
OTDA-4969 ELW can be filled out online or submitted through mail. The form requires information about the employer, employee, and details of the employment.
The purpose of OTDA-4969 ELW is to help the OTDA determine eligibility for various assistance programs based on the reported employment and income information.
Information such as employer details, employee details, wages, hours worked, and other relevant employment information must be reported on OTDA-4969 ELW.
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