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INFORMATION FOR EMPLOYER DB-102 (7-09)
A covered employer is authorized to collect from each employee, through payroll deduction, a contribution of 1/2 of. 1% of wages paid, but not in excess of 60
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Certification Of Payroll Statement
Proof of coverage must be on form C-105.2 (Certificate of Workers. Compensation Insurance) and must name this agency as a certificate holder. If New York State
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New York State Department of Labor - Public Work Forms
The use of this form meets payroll THIS CERTIFICATION MUST BE COMPLETED ON EACH WEEKLY PAYROLL FORM USED BY THE CONTRACTOR OR SUBCONTRACTOR.
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