Multi-page forms Two-page and multi-page forms must be printed and submitted to the Board of Directors in two-sided format. If this is not possible, submit it as separate sheets. However, DO NOT present on the map sheets that contain only instructions and/or reference material. Interveners other than the Commission must receive both sides of all two-page forms and all multi-page form pages. The forms are available in PDF format. The Council recommends using the latest version of Adobe Reader, which is available as a free download from the Adobe website. Once the form is open, you can fill it out by entering information in the form before printing it. If you are unable to open a form: (1) Download/save the form to your computer, (2) open Adobe Reader, (3) open the saved file. If you are still having problems with the form, please send an email to the board`s forms department. The new Form C2F replaced Form C2. This form can be completed and printed via the link below or electronically via the « Customers Only » section of this website.
If you wish to log in to complete this form electronically, please contact info@ncacomp.com for instructions on your username and password. Insurance certificates C-105, C-105.1, C-105.2, DB-120, DB-120.1 and DB-155 are not available on this website. Contact your insurance company or NYS licensed insurance agent to obtain these forms. Carriers and their authorized agents may email the Board of Directors to Certificates@wcb.ny.gov to obtain controlled forms that are not available on this website. Self-insured employers can contact the Office of Self-Insurance at selfinsurance@wcb.ny.gov to obtain the Certificate of Self-Insurance Coverage under the NYS Disability and Paid Family Leave Benefits Act (Form DB-155). If the form you are looking for is not listed at the top or in the list of common board forms, please send an email to the board`s forms department. The forms filled out by field above can be filled out in two ways: If you need help filling out these forms, please contact us. The package consists of new York State workers` compensation required forms that must be completed by the injured employee.
Please select a workers` compensation form below: This is a legal form published by the Workers` Compensation Board of the State of New York – a government agency operating in New York City. To date, no separate form submission guidelines are provided by the issuing service. Press the PRINT button to print only the current page. Download the document to your desktop, tablet or smartphone to print it in its entirety. Download a fillable version of Form C-240 by clicking on the link below, or browse other documents and templates provided by the New York State Workers` Compensation Board. .