Tables Of Statutory Employee Contributions Disability Benefits Law {DB-791} | Pdf Fpdf Doc Docx | New York

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Tables Of Statutory Employee Contributions Disability Benefits Law {DB-791} | Pdf Fpdf Doc Docx | New York

Tables Of Statutory Employee Contributions Disability Benefits Law {DB-791}

This is a New York form that can be used for Workers Compensation.

Alternate TextLast updated: 3/10/2017

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DB-791 (2-00) TABLES OF STATUTORY EMPLOYEE CONTRIBUTIONS DISABILITY BENEFITS LAW Amount of Statutory Contributions of Employees to the Cost of Providing Disability Benefits Effective July 1, 1983 - Section 209, subdivision 3 Table I - for employees paid weekly Table II - for employees paid daily Table III - for employees paid bi-weekly Table IV - for employees paid semi-monthly Table V - for employees paid monthly TABLE I (for employees paid weekly) WAGES $0.00 - 0.99 1.00 - 2.99 3.00 - 4.99 5.00 - 6.99 7.00 - 8.99 9.00 - 10.99 11.00 - 12.99 13.00 - 14.99 15.00 - 16.99 17.00 - 18.99 19.00 - 20.99 21.00 - 22.99 23.00 - 24.99 25.00 - 26.99 27.00 - 28.99 29.00 - 30.99 31.00 - 32.99 33.00 - 34.99 EMPLOYEE CONTRIBUTION None .01 .02 .03 .04 .05 .06 .07 .08 .09 .10 .11 .12 .13 .14 .15 .16 .17 2001 © American LegalNet, Inc. 35.00 - 36.99 37.00 - 38.99 39.00 - 40.99 41.00 - 42.99 43.00 - 44.99 45.00 - 46.99 47.00 - 48.99 49.00 - 50.99 51.00 - 52.99 53.00 - 54.99 55.00 - 56.99 57.00 - 58.99 59.00 - 60.99 61.00 - 62.99 63.00 - 64.99 65.00 - 66.99 67.00 - 68.99 69.00 - 70.99 71.00 - 72.99 73.00 - 74.99 75.00 - 76.99 77.00 - 78.99 79.00 - 80.99 81.00 - 82.99 83.00 - 84.99 85.00 - 86.99 87.00 - 88.99 89.00 - 90.99 91.00 - 92.99 93.00 - 94.99 95.00 - 96.99 97.00 - 98.99 99.00 - 100.99 .18 .19 .20 .21 .22 .23 .24 .25 .26 .27 .28 .29 .30 .31 .32 .33 .34 .35 .36 .37 .38 .39 .40 .41 .42 .43 .44 .45 .46 .47 .48 .49 .50 2001 © American LegalNet, Inc. 101.00 - 102.99 103.00 - 104.99 105.00 - 106.99 107.00 - 108.99 109.00 - 110.99 111.00 - 112.99 113.00 - 114.99 115.00 - 116.99 117.00 - 118.99 119.00 and over .51 .52 .53 .54 .55 .56 .57 .58 .59 .60 (Do not deduct more than $.60 per pay period for employees paid weekly.) TABLE II (for employees paid daily) WAGES $ 0.00 - 0.99 1.00 - 2.99 3.00 - 4.99 5.00 - 6.99 7.00 - 8.99 9.00 - 10.99 11.00 - 12.99 13.00 - 14.99 15.00 - 16.99 17.00 - 18.99 19.00 - 20.99 21.00 - 22.99 23.00 - 24.99 25.00 - 26.99 27.00 and over EMPLOYEE CONTRIBUTION None .01 .02 .03 .04 .05 .06 .07 .08 .09 .10 .11 .12 .13 .14 (Do not deduct more than $.14 per day for employees paid daily.) 2001 © American LegalNet, Inc. TABLE III (for employees paid bi-weekly) WAGES $0.00 - $118.99 119.00 - 120.99 121.00 - 122.99 123.00 - 124.99 125.00 - 126.99 127.00 - 128.99 129.00 - 130.99 131.00 - 132.99 133.00 - 134.99 135.00 - 136.99 137.00 - 138.99 139.00 - 140.99 141.00 - 142.99 143.00 - 144.99 145.00 - 146.99 147.00 - 148.99 149.00 - 150.99 151.00 - 152.99 153.00 - 154.99 155.00 - 156.99 157.00 - 158.99 159.00 - 160.99 161.00 - 162.99 163.00 - 164.99 165.00 - 166.99 167.00 - 168.99 169.00 - 170.99 171.00 - 172.99 173.00 - 174.99 EMPLOYEE CONTRIBUTION Use Table I .60 .61 .62 .63 .64 .65 .66 .67 .68 .69 .70 .71 .72 .73 .74 .75 .76 .77 .78 .79 .80 .81 .82 .83 .84 .85 .86 .87 2001 © American LegalNet, Inc. 175.00 - 176.99 177.00 - 178.99 179.00 - 180.99 181.00 - 182.99 183.00 - 184.99 185.00 - 186.99 187.00 - 188.99 189.00 - 190.99 191.00 - 192.99 193.00 - 194.99 195.00 - 196.99 197.00 - 198.99 199.00 - 200.99 201.00 - 202.99 203.00 - 204.99 205.00 - 206.99 207.00 - 208.99 209.00 - 210.99 211.00 - 212.99 213.00 - 214.99 215.00 - 216.99 217.00 - 218.99 219.00 - 220.99 221.00 - 222.99 223.00 - 224.99 225.00 - 226.99 227.00 - 228.99 229.00 - 230.99 231.00 - 232.99 233.00 - 234.99 235.00 - 236.99 237.00 - 238.99 239.00 - 240.99 .88 .89 .90 .91 .92 .93 .94 .95 .96 .97 .98 .99 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 (Do not deduct more than $1.20 per pay period for employees paid bi-weekly.) 2001 © American LegalNet, Inc. TABLE IV (for employees paid semi-monthly) WAGES 0.00 - 238.99 239.00 - 240.99 241.00 - 242.99 243.00 - 244.99 245.00 - 246.99 247.00 - 248.99 249.00 - 250.99 251.00 - 252.99 253.00 - 254.99 255.00 - 256.99 257.00 - 258.99 259.00 - and over EMPLOYEE CONTRIBUTION Use Table III 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 (Do not deduct more than $1.30 per pay period for employees paid semi-monthly.) TABLE V (for employees paid monthly) WAGES $0.00 - $258.99 259.00 - 260.99 261.00 - 262.99 263.00 - 264.99 265.00 - 266.99 267.00 - 268.99 269.00 - 270.99 271.00 - 272.99 273.00 - 274.99 275.00 - 276.99 277.00 - 278.99 279.00 - 280.99 EMPLOYEE CONTRIBUTION Use Table IV 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 1.40 2001 © American LegalNet, Inc. 281.00 - 282.99 283.00 - 284.99 285.00 - 286.99 287.00 - 288.99 289.00 - 290.99 291.00 - 292.99 293.00 - 294.99 295.00 - 296.99 297.00 - 298.99 299.00 - 300.99 301.00 - 302.99 303.00 - 304.99 305.00 - 306.99 307.00 - 308.99 309.00 - 310.99 311.00 - 312.99 313.00 - 314.99 315.00 - 316.99 317.00 - 318.99 319.00 - 320.99 321.00 - 322.99 323.00 - 324.99 325.00 - 326.99 327.00 - 328.99 329.00 - 330.99 331.00 - 332.99 333.00 - 334.99 335.00 - 336.99 337.00 - 338.99 339.00 - 340.99 341.00 - 342.99 343.00 - 344.99 345.00 - 346.99 347.00 - 348.99 1.41 1.42 1.43 1.44 1.45 1.46 1.47 1.48 1.49 1.50 1.51 1.52 1.53 1.54 1.55 1.56 1.57 1.58 1.59 1.60 1.61 1.62 1.63 1.64 1.65 1.66 1.67 1.68 1.69 1.70 1.71 1.72 1.73 1.74 2001 © American LegalNet, Inc. 349.00 - 350.99 351.00 - 352.99 353.00. - 354.99 355.00 - 356.99 357.00 - 358.99 359.00 - 360.99 361.00 - 362.99 363.00 - 364.99 365.00 - 366.99 367.00 - 368.99 369.00 - 370.99 371.00 - 372.99 373.00 - 374.99 375.00 - 376.99 377.00 - 378.99 379.00 - 380.99 381.00 - 382.99 383.00 - 384.99 385.00 - 386.99 387.00 - 388.99 389.00 - 390.99 391.00 - 392.99 393.00 - 394.99 395.00 - 396.99 397.00 - 398.99 399.00 - 400.99 401.00 - 402.99 403.00 - 404.99 405.00 - 406.99 407.00 - 408.99 409.00 - 410.99 411.00 - 412.99 413.00 - 414.99 415.00 - 416.99 1.75 1.76 1.77 1.78 1.79 1.80 1.81 1.82 1.83 1.84 1.85 1.86 1.87 1.88 1.89 1.90 1.91 1.92 1.93 1.94 1.95 1.96 1.97 1.98 1.99 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2001 © American LegalNet, Inc. 417.00 - 418.99 419.00 - 420.99 421.00 - 422.99 423.00 - 424.99 425.00 - 426.99 427.00 - 428.99 429.00 - 430.99 431.00 - 432.99 433.00 - 434.99 435.00 - 436.99 437.00 - 438.99 439.00 - 440.99 441.00 - 442.99 443.00 - 444.99 445.00 - 446.99 447.00 - 448.99 449.00 - 450.99 451.00 - 452.99 453.00 - 454.99 455.00 - 456.99 457.00 - 458.99 459.00 - 460.99 461.00 - 462.99 463.00 - 464.99 465.00 - 466.99 467.00 - 468.99 469.00 - 470.99 471.00 - 472.99 473.00 - 474.99 475.00 - 476.99 477.00 - 478.99 479.00 - 480.99 481.00 - 482.99 483.00 - 484.99 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.

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