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Nys wcb exemption 2026
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- Click ‘Get Form’ to open the NYS WCB Exemption form in the editor.
- Begin by entering your Social Security Number in the designated field at the top of the form.
- In the next section, print your full name clearly. This is essential for identification purposes.
- Fill in your residential address accurately to ensure proper communication regarding your exemption status.
- Next, provide the name of your employer and their place of employment. This information links your exemption claim to your current job.
- Indicate that you are receiving or entitled to receive primary old-age insurance benefits under Title Two of the Social Security Act by checking the appropriate box or writing a brief statement if required.
- Sign and date the form at the bottom, ensuring that you do this in front of a notary public as required.
- Finally, follow the instructions to mail one notarized copy to the Workers' Compensation Board and file another with your employer.
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