Printable blank CE-200 Form

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What is the CE-200 form?

CE-200 form is for companies only. It must be completed by the company that wants to receive an exemption of workers’ payments/compensations for disability. If there is a possible danger that may occur during the work, this form has to be completed. Read the Worker’s Compensation law article 1, section 3 for New York State, to check whether your situation matches requirements.

What I need the CE-200 for?

  • Any company with hazardous work has to complete this form to guarantee the coverage of disability insurance;
  • The form must be provided by Worker’s Compensation Board of the New York State;
  • Businesses that do not have employees working on the contracts with all the work performed outside the state must fill out the document in the first place;
  • When the disability is beneficial for exemption, this form should be filled out by businesses that function without workers in New York.

Filling out CE-200

CE-200 form does not actually require any additional documents to accompany it. And while it also does not have an actual due date, it is necessary to have it filled once you start the new project. The form is not hard to complete, however, you need to make sure that you fill out all the boxes and lines. Provide the next information:

  • Title, address, contact info of the applicant;
  • Information on the law entity;
  • Information about the contract itself;
  • Information about the location of the job. Remember, this is a New York’s State form;
  • Information on all the members of this business or partners;
  • You have to provide a real and well-described reason or several reasons for not obtaining the disability benefits or compensation.

Organizations that work with CE-200

Bureau of Compliance of the New York State.

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