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Statement terminatiing

Statement terminatiing 2026

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The document is an Employer's Statement for terminating status as a covered employer under New York's Disability Benefits Law. It outlines the necessary information and certifications required from employers to officially end their coverage, including employment history, employee contributions, and relevant legal provisions regarding employee definitions and termination of coverage.

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Click ‘Get Form’ to open the statement terminating document in the editor.
Begin by entering the Employer's Name in the first field. This identifies your business for the termination process.
Next, input your Employer's U.I. Registration Number and address in the designated fields to ensure accurate identification.
If your business operates under a different name, provide that information in the Business or Trade Name section.
In Section 4, answer questions regarding employee employment duration and contributions. Be sure to check 'Yes' or 'No' as applicable.
Complete any financial details regarding excess employee contributions, entering 'none' if there are no contributions.
Finally, sign and date the form at the bottom, ensuring all information is accurate before submission.

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