This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DB-212.3?
A: DB-212.3 is a notice form for corporations in New York to elect to exclude certain shareholders from disability and paid family leave benefits coverage.
Q: Who is this form for?
A: This form is for corporations in New York that are required to have disability and paid family leave benefits coverage for their employees.
Q: What does the form allow corporations to do?
A: The form allows corporations to exclude the sole shareholder-officer or one of two shareholder-officers or shareholder-officers of the corporation from disability and paid family leave benefits coverage.
Q: What is the purpose of excluding these shareholders from coverage?
A: The purpose is to provide flexibility for the corporation in managing its disability and paid family leave benefits coverage.
Form Details:
Download a fillable version of Form DB-212.3 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.