WC & DBL Forms
NY State Government Resources
Forms Online:
NYS Workers’ Compensation & DBL Common Forms
Workers’ Compensation:
C-2 Employers Report of Accident
C-3 Employee’s Claim for Compensation
C-11 Employer’s Report of Injured Employee’s Change in Status or Return to Work
C-22 Application for Approval of Non-Schedule Adjustment
C-32 Settlement Agreement
C-105.51 Notice of Election of a Corporation Which is Required to Have Coverage for its Employees Under The New York State Workers’ Compensation Law to Exclude the Sole Shareholder-Officer or One of the Two or Both Executive Officers-Shareholders of the Corporation from Such Coverage
C-121 Claim for Compensation and Notice of Commencement of Third Party Action
C-240 Employer’s Statement of Wage Earnings Preceding Date of Accident
C-257 Claimant’s Record of Medical and Travel Expenses
New York State Disability
DB 102 Information for Employer Regarding Disability Benefits Law
DB 125 Employer Identification Card
DB 212.5 Notice of Election To Voluntarily Exclude Spouse from Coverage
DB 300 Notice of Proof of Claim for Disability Benefits By Unemployed Claimant
DB 450 Notice and Proof of Claim for Disability Benefits
DB 791 Reference Table of Employee Contributions By Pay Period For Employer Use