Get Ny Ue-4m 2009

The New York UE-4m form is essential for employers seeking workers' compensation and employers' liability insurance through the New York State Insurance Fund. This guide provides step-by-step instructions to help you accurately fill out the form online and ensure all necessary information is submitted.

Follow the steps to complete the NY UE-4m form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the requested effective date of insurance in the format MM/DD/YYYY, ensuring the time is set for 12:01 A.M. Eastern Standard Time.
3. Provide the full name of the employer, including any trade or doing business as name. Additionally, specify the business type from the provided options.
4. Indicate the primary work location of the employer, ensuring not to use a P.O. Box, and provide all necessary contact information including telephone, fax, and email addresses.
5. If there is a representative, select 'Yes' and complete their contact information. If not, select 'No'.
6. Fill in how long your company has been in business with years and months.
7. Provide your latest experience modification factor and effective rating date if known.
8. Answer if you've been declined for coverage in the last 12 months and provide the necessary details if applicable.
9. Detail your business operations, including specific products or services offered.
10. List estimated annual payroll by type of work and duties for all employees, specifying if you wish to exclude executive officers or include partners/members.
11. For corporations, provide the state of incorporation and incorporation date.
12. List all business locations to be covered, ensuring they are all in New York State.
13. Provide further employer information including Federal Tax ID and NYS Unemployment ID.
14. Enter the name and address of your bank for payment processing.
15. Fill in contact information for the person you wish to designate for a premium audit.
16. Provide information on the sole proprietor, all executive officers, partners, or officials with applicable details.
17. If applicable, provide details about your disability benefits insurance and if you want a quote.
18. Record information concerning your general liability insurance.
19. Indicate if you have ever been in business under a different name and provide relevant details.
20. Answer if any principals of the corporation previously managed a business by another name, and provide details if applicable.
21. State if your business is an affiliate or subsidiary, along with relevant information if applicable.
22. Indicate if you are engaged in any other type of business and provide a description if so.
23. Specify if subcontractors or independent contractors are used in your operations.
24. Ensure payroll verification documentation is attached as required.
25. Read and acknowledge the information provided, sign, and date your application.
26. Once completed, save changes, and download, print, or share the form as needed.

Start filling out your NY UE-4m form online today to ensure your business is properly covered.