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New York State Department of Motor Vehicles DS-871 (6/11) ARTICLE 19-A DRIVER NOTIFICATION TO EMPLOYER www.dmv.ny.gov NOTE: This form may be used to meet the reporting requirements of Section 6.21
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How to fill out nys ds871 form
How to fill out the NYS DS871 form:
01
Obtain a copy of the NYS DS871 form from the appropriate source, such as the New York State government website or a local government office.
02
Review the instructions provided with the form to ensure that you understand the requirements and guidelines for completing it accurately.
03
Gather all the necessary information and supporting documents required to fill out the form, such as personal identification details, income information, and any relevant supporting documentation.
04
Start by entering your personal information accurately, including your full name, address, contact details, and social security number.
05
Provide the required information regarding your income, including details of employment, self-employment, or any other sources of income.
06
If applicable, provide information about any dependents, such as their names, ages, and relationship to you.
07
Carefully review the form to ensure that all the information provided is accurate and complete. Double-check for any errors or omissions.
08
Sign and date the form where indicated, certifying that all the information provided is true and accurate to the best of your knowledge.
09
Make a copy of the completed form for your personal records before submitting it.
10
Submit the NYS DS871 form to the designated authority or agency as specified in the instructions.
Who needs the NYS DS871 form:
01
Individuals who are applying for or are currently receiving benefits or services from the New York State government may need to fill out the NYS DS871 form.
02
This could include individuals applying for public assistance programs, Medicaid, or other government services in New York State.
03
The form may also be required for individuals who need to update or verify their existing information to ensure continued eligibility for benefits.
Please note that the specific requirements and circumstances may vary, so it is important to consult the instructions or seek guidance from the relevant authority to determine if the NYS DS871 form is required for your particular situation.
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What is nys ds871 form?
The NYS DS871 form is a form used by the state of New York for reporting certain information related to worker's compensation insurance.
Who is required to file nys ds871 form?
All employers in the state of New York who provide worker's compensation insurance are required to file the NYS DS871 form.
How to fill out nys ds871 form?
To fill out the NYS DS871 form, you need to provide information such as the employer's name and address, policy information, payroll information, and details about any claims made during the reporting period.
What is the purpose of nys ds871 form?
The purpose of the NYS DS871 form is to ensure compliance with worker's compensation insurance requirements and to provide information for monitoring and regulating the insurance system.
What information must be reported on nys ds871 form?
The NYS DS871 form requires the reporting of information such as the employer's name and address, policy details, payroll information, and information about any claims made during the reporting period.
When is the deadline to file nys ds871 form in 2023?
The deadline to file the NYS DS871 form in 2023 is typically on or before March 1st.
What is the penalty for the late filing of nys ds871 form?
The penalty for the late filing of the NYS DS871 form can vary, but it may result in fines or other enforcement actions imposed by the relevant authorities.
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