Get Ny Nysif Udb-36 2018-2025

Completing the NY NYSIF UDB-36 form is an essential step for employers looking to apply for disability benefits insurance in New York. This guide provides clear, step-by-step instructions to help users effortlessly fill out the form online and ensure all necessary information is included.

Follow the steps to successfully complete the application.

1. Press the ‘Get Form’ button to access the UDB-36 application form and open it in your online editor.
2. Begin by entering the policy inception date, which should be the day following the postmark date unless you request a future date. Input the desired future inception date in the format MM/DD/YYYY.
3. Fill in the business information section, including the legal business name, Federal Tax ID or SSN if applicable, 'doing business as' (DBA) name if any, telephone number, complete address (no P.O. boxes), city, contact person's name, state, zip, country, and contact email.
4. If your mailing address is different from the business address, provide the new mailing address including city.
5. Select the legal entity type by checking the appropriate box: Corporation, Sole-Proprietor, Partnership, LLC, LLP, Union, Not-for-profit, or Other. Additionally, indicate the nature of your business and provide the Standard Industrial Classification (SIC) code.
6. If you have an additional entity, complete that section by providing the entity name, Federal Tax ID, entity type, business address, and other relevant contact information.
7. In the insurance broker or representative section, enter the agency name, address, contact name, city, email, state, zip, country, and telephone.
8. Fill in the current insurance provider information, which includes the workers’ compensation insurance carrier, current disability benefits insurance provider, and total dollar amount of disability claims for the last three years.
9. Choose coverage options for disability claims by selecting the appropriate box for statutory benefit coverage or enriched benefit coverage. If selecting enriched, indicate the desired multiple of the statutory benefit.
10. Specify whether employees contribute to the disability benefits insurance premium by selecting the corresponding option.
11. Complete the payroll information section, including the number of covered employees and total wages for all employees, adhering to the specified annual caps.
12. Include the printed name and original signature of the owner, partner, officer, or member of the organization, along with the respective dates.
13. Finally, review all entered information for accuracy, then proceed to save changes, download, print, or share the completed form as needed.

Start your application today by filing the NY NYSIF UDB-36 form online!