New York > Workers Compensation
Electronic Attachment - New York
|Electronic Attachment Form. This is a New York form and can be used in Workers Compensation .||
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State of New York Workers' Compensation Board Attachment to Form Claimant's Last Name Dated Claimant's First Name WCB Case Number Carrier Case Number Claimant's Soc. Sec. No. Date of Accident or Injury Electronic Attachment (05/01) 2002 © American LegalNet, Inc.