Get State Of New York Workers Compensation Board Certificate Of Insurance Coverage Under The Nys

Filling out the State of New York Workers Compensation Board Certificate of Insurance Coverage can be a straightforward process when you know how to approach it. This guide provides clear, step-by-step instructions to assist you in completing the form online effectively.

Follow the steps to complete your certificate of insurance coverage.

1. Click ‘Get Form’ button to obtain the form and open it in the editing interface.
2. In Part 1, begin filling out the legal name and address of the insured. Ensure you use the street address only and include any additional contact information, such as the business telephone number.
3. Provide the NYS Unemployment Insurance Employer Registration Number, and if applicable, the Federal Employer Identification Number or Social Security Number for the insured.
4. Next, complete the name and address of the entity requesting proof of coverage by accurately filling in all necessary details.
5. In the designated section, input the name of the insurance carrier and the policy number associated with the entity listed.
6. Fill in the policy effective period, ensuring to indicate the start and end dates of the coverage.
7. Indicate whether the policy covers all employees or specific classes of employees of the insured.
8. Once all information is accurately filled, the authorized representative must sign and date the form, certifying that the information is correct.
9. After completing all sections of the form, users can save their changes, download, print, or share the finished document as needed.

Complete your documents online to ensure timely compliance and coverage.