The New York Initial Application To Take License Rep Exam To Appear On Behalf of Claimants Or To Represent Carriers-Self-Insurers is a form that must be completed by individuals who are interested in becoming a licensed representative to represent claimants or carriers-self-insurers on behalf of the State of New York. This form is a requirement for individuals who wish to take the license representative exam. The exam is administered by the New York Department of Financial Services. The New York Initial Application To Take License Rep Exam To Appear On Behalf of Claimants Or To Represent Carriers-Self-Insurers comes in two forms: an individual application and a company or organization application. Both forms require the individual to provide information about their background, such as name, address, contact information, and any relevant education or experience. The form also requires the individual to provide information about the company or organization they will be representing, including the company name, contact information, and a description of the services the company provides. Once the application is completed and submitted, the individual must pass the license representative exam in order to qualify for the license. After successfully passing the exam, the individual will receive a license that will allow them to represent claimants or carriers-self-insurers on behalf of the State of New York.
New York Initial Application To Take License Rep Exam To Appear On Behalf of Claimants Or To Represent Carriers-Self-Insurers
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FAQ
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.
WCB means the Workers Compensation Board.
Accepted Forms: U26.3 ? Certificate of Workers' Compensation Ins (NYS Insurance Fund only)
If you filed a claim and were assigned a number, you can call (646)264-3000 for information about your claim. If you are a U.S. Department of Labor employee, please call (816)502-0301 for claim status information.