NY DB-135 2003 free printable template
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STATE OF NEW YORK WORKERS COMPENSATION BOARD DISABILITY BENEFITS BUREAU 100 BROADWAY MEANS ALBANY, NY 12241-0005 THIS AGENCY EMPLOYS AND SERVES PEOPLE WITH DISABILITIES WITHOUT DISCRIMINATION. EMPLOYER
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How to fill out NY DB-135
How to fill out NY DB-135
01
Obtain the NY DB-135 form from the New York State Department of Labor website or local office.
02
Fill in your personal information, including your name, address, and contact information.
03
Provide details regarding your employment, including your employer's name and address.
04
Include the date of your injury or illness and a brief description of what happened.
05
Ensure to include any relevant medical information or documentation if applicable.
06
Review the form for completeness and accuracy.
07
Sign and date the form.
08
Submit the form to the appropriate office, either in person or via mail.
Who needs NY DB-135?
01
Employees who have suffered a work-related injury or illness.
02
Workers seeking to file a claim for workers' compensation benefits.
03
Individuals wanting to report an incident for legal or insurance purposes.
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What is NY DB-135?
NY DB-135 is a form used in New York for reporting of benefits and information related to disability insurance.
Who is required to file NY DB-135?
Employers who participate in the New York State Disability Benefits Law are required to file NY DB-135.
How to fill out NY DB-135?
To fill out NY DB-135, you must provide the required information regarding the employee, including details about their disability and the benefits being claimed.
What is the purpose of NY DB-135?
The purpose of NY DB-135 is to ensure that employees receive the disability benefits they are entitled to under New York State law.
What information must be reported on NY DB-135?
The information that must be reported on NY DB-135 includes the employee's personal information, the nature of the disability, and the relevant dates related to the disability and claim.
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