Free Ce200 PDF Template

1. What is the CE-200 form?

   The CE-200 form, known as the Application for Certificate of Attestation of Exemption from New York State Workers' Compensation and/or Disability Benefits Insurance Coverage, is a document that certain entities can complete to certify exemption from carrying workers' compensation and/or disability benefits insurance in New York State. This form is applicable to entities without employees, or out-of-state entities working entirely outside New York, among other specific qualifiers.

2. Who can file for a CE-200 form?

   The CE-200 form may only be filed by entities without employees, entities whose employees are not engaged in work in New York State for more than 30 days in a calendar year, or out-of-state entities that are contracted for work entirely performed outside of New York State.

3. What purposes does the CE-200 serve?

   The CE-200 form is used to attest to a government entity that the applicant requesting a permit, license, or contract from that government entity is not required to carry workers’ compensation and/or disability benefits insurance. This is a critical step in obtaining certain permits, licenses, or contracts within New York State.

4. How is the CE-200 form submitted?

   The application must be completed in its entirety and submitted to the Workers’ Compensation Board either by mail or fax. It is processed in the order received, and a certificate of attestation of exemption will be mailed to the applicant.

5. Is there a faster way to obtain a certificate of attestation of exemption?

   Yes, for immediate processing, applicants can use the online application available at the Workers’ Compensation Board's official website. Upon completion of the online application, the certificate of attestation of exemption can be printed directly by the applicant.

6. How long does it take to process a CE-200 form?

   The processing time for a CE-200 form may take up to four weeks after submission. However, using the online application process can significantly expedite this timeframe, allowing the applicant to immediately print the certificate upon completion.

7. What information is needed to fill out the CE-200 form?

   Applicants need to provide personal information, details about their business or legal entity, the nature of the business activity, information regarding the specific permit, license, or contract being sought, and a detailed explanation of why workers’ compensation and/or disability benefits insurance coverage is not required.

8. Can an accountant or lawyer file the CE-200 form on behalf of a client?

   No, the application must be filed by the individual who has the knowledge, information, and legal authority to make the application. This means an accountant or lawyer cannot submit the form on behalf of their clients, but they can assist in preparing the information needed.

9. What happens if false information is provided on the CE-200 form?

   Providing false information on the CE-200 form is a serious matter that can lead to felony prosecution, imprisonment, and civil liabilities under the Workers’ Compensation Law and other New York State Laws. The application is made under the penalties of perjury, affirming the truthfulness and accuracy of the provided information.

10. Where can I find more information or get help filling out the CE-200 form?

    While employees of the Workers’ Compensation Board cannot assist in completing the form, applicants are encouraged to contact an attorney for legal questions. For more specific questions about the form or the application process, visiting the official website of the New York State Workers' Compensation Board provides comprehensive resources and contact information for further assistance.

1. One common mistake is the incorrect or incomplete provision of personal information in section 1. Applicants must ensure they accurately fill out their first and last names, street address, city, state, zip code, country (if not the U.S.), and personal phone number. Missing or inaccurate details can result in processing delays or application denial.

2. In section 2, selecting the incorrect title or failing to specify "Other" with the appropriate designation can lead the Workers’ Compensation Board to question the applicant's legitimacy or role within the entity. This specificity is crucial for establishing the applicant's authority to request the exemption.

3. Not correctly entering the Federal ID number or social security number in section 3, under "Legal Entity Information," is another mistake that can have significant ramifications. This error could lead to issues in verifying the entity's legal standing or could even result in a mismatch or confusion with another entity's records.

4. Applicants sometimes choose the wrong nature of business in section 4.A or incorrectly describe the permit, license, or contract they are acquiring in section 4.B. This can lead to improper assessment of the application or outright rejection if the nature of the business does not align with the exemption criteria.

5. Omission of job site location information in section 5, when applying for a building, plumbing, or electrical permit, is a prevalent error. Providing detailed and accurate job site information, including the street address, city, state, zip code, county, dates of the project, and estimated dollar amount, ensures the Workers' Compensation Board can assess the application accurately.

6. In section 6, failing to list all partners, members, corporate officers (with their titles), or incorrectly skipping this section if applicable, can invalidate the application. For entities other than sole proprietorships, this comprehensive listing validates the operational and functional hierarchy of the business, which is necessary for exemption consideration.

Aside from these specific sections, a general oversight is not reviewing the completed form for accuracy and completeness before submission. Even small errors or omissions can lead to significant delays in the processing of the CE-200 form or result in the need to re-submit the application entirely. Therefore, careful review and adherence to the detailed instructions provided by the Workers' Compensation Board are essential for a successful exemption request.

When completing the CE-200 form, an Application for Certificate of Attestation of Exemption from New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage, individuals frequently need to submit additional documentation to support their application or to fulfill other legal requirements. Here's a look at six other forms and documents often used in conjunction with the CE-200 form:

• Form CE-200 Instructions: Before filling out the CE-200 application, it's crucial to review its separate instruction document. This document provides detailed instructions on how to correctly complete the form and clarifies any questions regarding the application process.
• Proof of Identification: Often, a government-issued photo ID such as a driver's license or passport is required to verify the identity of the applicant. This ensures the application is being submitted by an authorized individual.
• Business Formation Documents: For entities other than sole proprietors, documents that establish the legal formation of the business (such as articles of incorporation for corporations or articles of organization for limited liability companies) may be required. These documents prove the legal standing and structure of the business seeking exemption.
• Financial Statements: In certain situations, recent financial statements might be necessary to verify the financial status of the business. This can include payroll records to demonstrate that there are no employees or that employees work out of state.
• Risk Assessment Reports: Some applications may require a risk assessment report to determine the need for workers’ compensation and disability benefits insurance. This is more common in industries with higher risks of injury.
• Letter of Explanation: If there are unique circumstances or additional details that need to be communicated regarding the exemption request, a letter of explanation can be included with the application. This letter can clarify any questions the reviewing authority might have about the application.

It's important for applicants to carefully review the CE-200 form instructions and any additional requirements from the New York State Workers’ Compensation Board. Ensuring that all necessary documents are complete and accurate can aid in a smooth and expedited application process. Always remember, the specific requirements can vary based on the nature of the application and the specifics of the business or entity applying for the exemption.

• Certificate of Liability Insurance: Similar to the CE200 form, this document serves as proof that a business possesses necessary insurance coverage. While the CE200 form provides exemption proof for workers' compensation and/or disability benefits insurance, the Certificate of Liability Insurance proves a business has general liability insurance. Both are often required to contract with government entities or obtain permits and licenses.

• Independent Contractor Exemption Certificate (ICEC): Similar to the CE200, an ICEC allows individual contractors to attest that they meet the criteria to operate as independent contractors and, as such, are not subject to certain state employment taxes or workers' compensation insurance requirements. Both documents focus on affirming a status to avoid specific insurance coverage obligations.

• W-9 Form: The Request for Taxpayer Identification Number and Certification, or Form W-9, is akin to the CE200 in that it is often required ahead of starting business engagements, especially when independent contractors are involved. The CE200 form is used for insurance exemption; the W-9 ensures proper reporting to the IRS. Both are necessary for regulatory compliance in business transactions.

• Zoning Compliance Certificate: This document is similar to the CE200 in that it's necessary for proving compliance with certain regulatory requirements—zoning laws in this case—usually for obtaining permits or licenses. The CE200 proves compliance with insurance requirements, while a Zoning Compliance Certificate attests compliance with local zoning laws.

• Building Permit: While the CE200 form relates to insurance exemption, the Building Permit is aimed at construction authorization. Both are required for conducting specific business activities legally: the CE200 for exempt entities engaging in activities that normally would require workers’ compensation or disability benefits insurance, and the Building Permit for construction or renovation projects within certain jurisdictions.

When you're filling out the CE-200 form for the New York State Workers' Compensation Board, it's essential to do it carefully to ensure you're correctly exempted from carrying workers’ compensation and/or disability benefits insurance. Here are some guidelines to help you out:

• Read the instructions before you start filling out the form. This can save you from making mistakes.
• Complete the application in its entirety. Partially filled applications can result in processing delays or denials.
• Ensure all information provided is accurate and truthful. Falsifying information can lead to severe consequences including felony charges.
• Check the eligibility criteria thoroughly. This form is only for entities that meet specific requirements relating to employees and work location.
• Use the online application system if you need the certificate immediately. It’s faster and you can print the certificate right after.
• If you are mailing the form, make sure it's sent to the correct address to avoid delays.
• Sign and date the application affirming the information is correct and that you are authorized to make the exemption request.

• Don’t leave sections incomplete. If a section doesn’t apply, clearly mark it as N/A (Not Applicable).
• Avoid guessing on any information. Confirm all details before entering them on the form.
• Don’t use information that is outdated or no longer accurate, such as previous addresses or old business names.
• Resist the urge to rush through the form. Taking your time can prevent errors that might delay processing.
• Don’t assume you don’t qualify without checking all the criteria. If in doubt, review the eligibility requirements again or seek advice.
• Never sign the form without verifying that all the information is correct and complete.
• Do not ignore the instructions and additional information on the reverse side of the form. This information can be crucial for a successful application.

Remember, the CE-200 form is an essential document for entities seeking exemption from New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage. Filling it out correctly the first time can save unnecessary delays or problems. If you're unsure about any part of the application process, it might be beneficial to consult with a legal expert.

When dealing with the CE-200 form, it's crucial to address and clarify common misconceptions to ensure entities are properly exempt from New York State Workers’ Compensation and/or Disability Benefits Insurance coverage. Below are ten common misunderstandings:

1. All businesses can use the CE-200 form for exemption. Incorrect. Only entities with no employees, or out-of-state entities performing all work outside of New York State, can complete this application for workers’ compensation exemption. For disability benefits exemption, entities without employees or those with employees working less than thirty days in a calendar year in NYS are eligible.

2. Completion guarantees exemption. Simply completing the CE-200 form does not guarantee exemption. The application must be fully completed, submitted, and then approved.

3. The form serves multiple purposes. The CE-200 form is strictly used to attest to a government entity that the applying business is not required to carry workers' compensation and/or disability benefits insurance for obtaining permits, licenses, or contracts.

4. Instant approval is available. While an online submission can provide immediate proof of application, the processing and approval of an exemption can take up to four weeks.

5. Any correspondence can be substituted for the official certificate. Only the official certificate of attestation of exemption issued by the Workers' Compensation Board can be used as proof of exemption.

6. Electronic submission is the only method. While the online application provides an immediate certificate, applicants can also submit their application via fax or mail, though these methods take longer to process.

7. Legal assistance is provided for form completion. The Workers’ Compensation Board staff cannot assist in completing the application. Legal advice should be sought independently if required.

8. One form covers all business entities. Each legal entity requiring an exemption must submit a separate CE-200 form. Consolidated applications are not permitted.

9. The form itself provides legal exemption in court. The certificate of attestation of exemption is valid only for governmental permitting or contracting purposes and does not serve as legal immunity in cases of worker injury or disability disputes.

10. An exemption once granted is permanent. Changes in business structure, employee status, or work scope may void the exemption, requiring a new application to determine current eligibility.

Clarifying these misconceptions ensures that entities accurately complete and submit the CE-200 form, fostering compliance with New York State regulations.

The CE-200 form, officially titled "Application for Certificate of Attestation of Exemption from New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage," is critical for certain entities in New York. It's particularly relevant for entities without employees or for out-of-state entities working exclusively outside New York State. Here are ten essential takeaways regarding filling out and using this form effectively:

• Eligibility to complete the CE-200 form is reserved exclusively for entities with no employees or out-of-state entities that undertake contracts with all work performed outside of New York State.
• To apply for an exemption from New York State disability benefits, entities without employees or those with non-manual employees working in New York State for less than thirty days in a calendar year may fill out this form.
• The primary purpose of this certificate is to prove to a government entity that the applicant seeking a permit, license, or contract is exempt from holding workers’ compensation and/or disability benefits insurance.
• Applicants must complete the application in full and submit it to the Workers' Compensation Board either via mail or fax for processing, which may take up to four weeks.
• An immediate certificate of attestation of exemption is available through the online application process at the Workers’ Compensation Board's website, which allows for the direct printing of the certificate.
• Applicant information, including personal and legal entity details, must be provided clearly and accurately in the sections outlined in the form.
• The form includes sections to detail the nature of the business, the specific permits, licenses, or contracts applied for, and the identification of the government agency issuing the permit or license.
• It's important to list all partners, members, or corporate officers associated with the legal entity, except in cases of sole proprietorship where this section may be skipped.
• Applicants must select the specific reason(s) why the legal entity is not required to obtain New York State specific Workers' Compensation Insurance Coverage or Statutory Disability Benefits Insurance Coverage as applicable.
• Lastly, the affirmation section at the end of the application underscores the seriousness and legal implications of the information provided. It requires the signature of the applicant, asserting the truthfulness and accuracy of all information provided under penalty of perjury.

Filling out the CE-200 form accurately is crucial for entities seeking exemption from New York State's workers' compensation and/or disability benefits insurance. By understanding these key points, applicants can navigate the process more effectively and ensure compliance with state requirements.