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Get NY UE-4m 2013-2024

1 Watervliet Ave. Extension, Albany, NY 12206 APPLICATION FOR NEW YORK WORKERS’ COMPENSATION AND EMPLOYERS’ LIABILITY INSURANCE Any person who wilfully makes a false statement or representation, deliberately conceals any material fact, or engages in any other fraudulent scheme or device, for the purpose of obtaining or attempting to obtain, or for the purpose of aiding or abetting any person to obtain insurance in the New York State Insurance Fund at less than the proper rate for such ins.

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