NY DB-691 2012 free printable template
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STATE OF NEW YORK WORKERS COMPENSATION BOARD 328 STATE STREET SCHENECTADY, NY 12305 ANDREW M. CUOMO (518) 402-0247 ROBERT E. BEATEN GOVERNOR CHAIR IMPORTANT NOTICE To Self-Insurers Providing Benefits
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How to fill out NY DB-691
How to fill out NY DB-691
01
Obtain the NY DB-691 form from the New York State Department of Labor website or your local office.
02
Fill in your personal information including your name, address, and Social Security number.
03
Indicate the type of employment you were engaged in.
04
Provide the dates of your employment, including start and end dates.
05
Detail your earnings during the period of employment.
06
Include any additional information requested, such as reasons for separation or layoffs.
07
Review the form for accuracy and completeness before submission.
08
Submit the completed form either online, by mail, or in person as directed.
Who needs NY DB-691?
01
Individuals who are applying for unemployment benefits in New York State.
02
Employees seeking an official statement of their employment history.
03
Employers needing to report employee separation for benefits processing.
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What is NY DB-691?
NY DB-691 is a form used in New York to report information regarding the establishment and operation of a business that is required to comply with the state's disability benefits law.
Who is required to file NY DB-691?
Employers in New York who required to provide disability benefits to their employees must file NY DB-691.
How to fill out NY DB-691?
To fill out NY DB-691, employers must complete all required sections of the form, provide accurate information about their business and disability benefits coverage, and submit it to the appropriate state agency.
What is the purpose of NY DB-691?
The purpose of NY DB-691 is to ensure that employers are compliant with state regulations regarding disability benefits and to maintain proper records for enforcement and auditing purposes.
What information must be reported on NY DB-691?
Information that must be reported on NY DB-691 includes the employer's details, the type of disability benefits coverage provided, the number of employees, and other related business information.
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