Db 135 form 2026

See details

4.8 out of 5

90 votes

The document is an application for voluntary coverage of disability and paid family leave benefits by an employer in New York State, specifically for classes of employees not required by law to have such benefits. It outlines the employer's details, the classes of employees covered, the benefits to be provided, and the method of providing these benefits, either through insurance or self-insurance. The employer agrees to cover costs without employee contributions and must provide notice before discontinuing coverage.

Here's how it works

01. Edit your db 135 online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send 135 form pdf via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out db 135 form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the db 135 form in the editor.
Begin by entering your business details, including the Name of Employer, Business Name, Telephone Number, and Address in the designated fields.
Provide your Federal Employer's Identification Number or Social Security Number if applicable, along with the Total Number of Employees.
Indicate the number of employees for whom disability and paid family leave benefits are not required by law.
In section A, select whether you are a covered employer as defined by New York State law.
Complete section B by specifying which employees are covered and detailing the benefits to be provided.
In section C, confirm your agreement regarding employee contributions and payment of benefits. Ensure you sign and date the form at the bottom.

Start filling out your db 135 form online for free today!