NY DB-130 2002 free printable template
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State of New York WORKERS COMPENSATION BOARD EMPLOYEE IS STATEMENT OF EXEMPT STATUS Social Security Number I, (PLEASE PRINT FULL NAME) residing at an employee of (Name of Employer) at (Place of Employment)
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Download the NY DB-130 form from the official website.
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Begin by filling out your personal information at the top section, including your name, address, and contact details.
03
Follow the prompts to input information regarding the financial disclosures required.
04
Make sure to include all necessary supporting documents as outlined in the instructions.
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Review your completed form for accuracy and completeness.
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Sign and date the form where indicated.
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Submit the form as per the submission guidelines provided (either electronically or by mail).
Who needs NY DB-130?
01
Individuals who are filing for divorce or seeking a legal separation in New York.
02
Parties involved in child support or spousal support cases that require financial disclosures.
03
Anyone mandated by the court to disclose their financial information in a family law case.
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What is NY DB-130?
NY DB-130 is a form used in New York State for reporting certain information related to employee benefits and payroll.
Who is required to file NY DB-130?
Employers who are subject to New York State's disability benefits law are required to file the NY DB-130 form.
How to fill out NY DB-130?
To fill out NY DB-130, employers must complete the required sections including employee information, employer details, and the relevant benefit information as outlined in the form's instructions.
What is the purpose of NY DB-130?
The purpose of NY DB-130 is to ensure compliance with New York State's disability benefits law by providing documentation of benefits provided to employees.
What information must be reported on NY DB-130?
NY DB-130 must report information such as the employee's name, Social Security number, dates of disability, benefits provided, and employer's details.
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