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New York Attorney-Representatives Certification of Form C-3 Or Notice of Controversy

State:
New York
Control #:
NY-OC-400.5-WC
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Attorney-Representatives Certification of Form C-3 Or Notice of Controversy

The New York Attorney-Representatives Certification of Form C-3 Or Notice of Controversy is a document used in the state of New York by attorneys representing clients in civil legal matters. The document, also known as Form C-3, is used to provide notice to the court of an attorney's representation of a particular party in a civil action. The document is typically filed along with the initial complaint or other court filing, but may also be filed anytime an attorney wishes to appear on behalf of a party. The document is intended to provide notice of an attorney's appearance in a civil action, as well as to certify the attorney's status as a New York attorney. The document must be signed by the attorney and notarized by a notary public. The document has two types: 1. New York Attorney-Representatives Certification of Form C-3: This is completed by attorneys when they are initially appearing on behalf of a party in a civil action in New York. 2. Notice of Controversy: This is completed by attorneys when they are later appearing as substitute counsel in a case, or when they are filing motions in a case. This document must also be signed by the attorney and notarized.

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Your employer is not allowed to: Discriminate against you because you have filed, or are planning to file a workers' compensation claim. Example: Your employer is not allowed to fire you because you have filed a workers' compensation claim.

Or fax your complaint to us at (518) 486-3745. You may also file a complaint by calling our toll free hot line at 1 (800) 367-4448. This will connect you with trained staff who can discuss with you the specifics of your complaint.

James A. Tacci, MD, JD, MPH (FACOEM, FACPM), is the Medical Director of the NYS Workers' Compensation Board.

A detailed narrative progress/supplemental report is filed to document any significant change in the worker's medical or disability status.

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SI-12 (7/09) Affidavit Certifying That Compensation Has Been Secured. Employers with Board-approved self-insurance for workers' compensation. Filed with the government agency issuing a permit, license or contract. The SI-12 must be completed by the Board's Self-Insurance Office and approved by the Board's Secretary.

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Attorney-Representatives Certification Of Form C-3 Or Notice Of Controversy Form. This is a New York form and can be use in Workers Compensation.38 on reverse of this form for complete filing instructions). 3 forms follow the text of this document. NY Form C-105 – Notice of Compliance – Workers' Compensation Law . I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. These are the most frequently requested U.S. Department of Labor forms. You can complete some forms online, while you can download and print all others. Items 1 - 7 — 202. 7 Calendaring of motions; uniform notice of motion form; .

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New York Attorney-Representatives Certification of Form C-3 Or Notice of Controversy