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 Form C-105.4?
A: Form C-105.4 is a form used to revoke the election of an incorporated religious, charitable, educational, or U.S. War Veterans organization to bring executive officers under the coverage of the New York Workers' Compensation Law.
Q: Who uses Form C-105.4?
A: Incorporated religious, charitable, educational, or U.S. War Veterans organizations use Form C-105.4 to revoke their election to bring executive officers under the coverage of the New York Workers' Compensation Law.
Q: What does revoking the election mean?
A: Revoking the election means that the organization is deciding not to include their executive officers under the coverage of the New York Workers' Compensation Law.
Q: What is the purpose of the New York Workers' Compensation Law?
A: The purpose of the New York Workers' Compensation Law is to provide wage replacement and medical benefits to employees who are injured or become ill due to their work.
Form Details:
Download a printable version of Form C-105.4 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.