Form C240 Download Fillable PDF or Fill Online Employer's Statement of
Form C-240. Promptly report accurate wage and attendance information about the injured worker to nysif by submitting form c. Employer's statement of wage earnings preceding date of accident.
Within 10 days of request by the board. • attaching payroll documentation, which includes days worked and wages per week for the prior. Promptly report accurate wage and attendance information about the injured worker to nysif by submitting form c. Employer's statement of wage earnings preceding date of accident.
Promptly report accurate wage and attendance information about the injured worker to nysif by submitting form c. Employer's statement of wage earnings preceding date of accident. Within 10 days of request by the board. • attaching payroll documentation, which includes days worked and wages per week for the prior. Promptly report accurate wage and attendance information about the injured worker to nysif by submitting form c.
