Nys oca forms

    • [PDF File]STATE OF NEW YORK - WORKERS' COMPENSATION BOARD

      https://info.5y1.org/nys-oca-forms_1_2ad5fb.html

      NYS Workers' Compensation Board, PO Box 5205, Binghamton, NY 13902-5205 . Customer Service: (877) 632-4996 Statewide Fax: (877) 533-0337 § 300.17 Notices of retainer, appearance, substitution and withdrawal, and fees of claimant's attorney or licensed representative.

    • [PDF File]Tiers 3, 4, 5 & 6 Loan Application for Members Covered by ...

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      The official responsible for record maintenance is the Director of Member and Employer Services, NYS and Local Retirement System, Albany, NY 12244; call toll-free at 1-866-805-0990 or 518-474-7736 in the Albany Area.

    • [PDF File]REQUEST FOR JUDICIAL INTERVENTION UCS-840

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      RELATED CASES List any related actions. For Matrimonial cases, list any related criminal or Family Court cases. If none, leave blank. If additional space is required, complete and attach the RJI ADDENDUM (UCS-840A). Case Title Index/Case Number Court Judge (if assigned) Relationship to instant case

    • [PDF File]NYS UNIFIED COURT SYSTEM (UCS) P&CS RFP #039 OFFICE OF ...

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      UCS/OCA may have regarding bidder’s bid/proposal response. Bidder shall include in its bid/proposal response all forms, documents and information required herein. Packaging, Identifying and Delivering of Proposals Proposals must be clearly addressed and submitted to: Amelia Hershberger New York State Unified Court System

    • [PDF File]NOTE OF ISSUE

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      Postal Service within New York State. Sworn before me on the day of , 20 Notary Public . The certificate of readiness states the items that are necessary for trial have been completed, waived by a party or not required. Items 1-7 must be checked. Affidavit of Service: Use the left side of the form if you have served the papers personally upon ...

    • [PDF File]STATE OF NEW YORK NYS OFFICE OF COURT ADMINISTRATION ...

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      OCA/JI-251 Commodity Group: Opening Date: 04/10/2019 Time: 3:00 pm Issue Date: 03/20/2019 Commodity Name: 2019 Summer Judicial Seminars NYS OFFICE OF COURT ADMINISTRATION Division of Financial Management 4 ESP – Suite 2001, 19th Fl. Albany, NY 12223-1450 (Agency Name and Address) Direct Inquiries to: Marie-Claude Ceppi E-mails: mceppi ...

    • [PDF File]UCS-111 (rev. 1/25/16) CHILD SUPPORT SUMMARY FORM SUPREME ...

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      UCS-111 (rev. 1/25/16) NEW YORK STATE UNIFIED COURT SYSTEM SUPPORT SUMMARY FORM: SUPREME COURT INSTRUCTION SHEET Prepare one report for each proposed judgment or final order granted pursuant to Article 4 or 5 of the Family Court Act and

    • [PDF File]Application for Service Retirement (RS6037)

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      Office of the New York State Comptroller Subject: To apply to receive a pension benefit, NYSLRS members use form RS6037. Keywords: new york state and local retirement system, nyslrs, employees retirement system, ers, police and fire retirement system, pfrs, members, application for service retirement, rs6037 Created Date: 1/23/2018 10:23:01 AM

    • [PDF File]SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF

      https://info.5y1.org/nys-oca-forms_1_154144.html

      [UCS Rev. 6/2016 eff. 8/1/16 (8/12/16 version)] Page 6 3. Music (Digital or Physical Media) 4. Recreation Clubs and Memberships 5. Activities for yourself

    • [PDF File]AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT ...

      https://info.5y1.org/nys-oca-forms_1_883823.html

      OCA Official Form No.: 960 . AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT TO HIPAA ... I may contact the New York State Division of Human Rights at (212) 480-2493 or the New York City Commission of Human Rights at (212) 306-7450. These agencies are responsible for protecting my rights. 3.

    • [PDF File]UNIFORM UNCONTESTED DIVORCE PACKET FORMS

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      (Important Note: LDSS-5037 and LDSS-5038 are the actual Forms) A-2B Income Withholding for Support: General Information and Instructions for Issuing - LDSS-5039* (Important Note: Do not complete this form. Use it as a guide when filling out the actual Forms. ) B. New York State Case Registry Filing Form with Instructions attached C. Notice of ...

    • [PDF File]DENTAL CLAIM FORM-04132016163555 - New York State Court ...

      https://info.5y1.org/nys-oca-forms_1_6adee3.html

      New York State Court Clerks Association Security Benefits Fund c/o Daniel H. Cook Associates 253 West 35th Street 12th Floor New York, NY 10001 -1907 Telephone (212) 505-5050 NOTICE TO DENTISTS There is no assignment of benefits under this dental program unless you are a participating provider.

    • [PDF File]NEW YORK STATE UNIFIED COURT SYSTEM EMPLOYEE HANDBOOK

      https://info.5y1.org/nys-oca-forms_1_7721a4.html

      The mission of the New York State Unified Court System is to promote the rule of law and to serve the public by providing just and timely resolution of matters before the courts. New York State Government New York State government is comprised of three branches. The Legislative Branch is responsible for

    • [PDF File]OCA Official Form No.: 960 AUTHORIZATION FOR RELEASE OF ...

      https://info.5y1.org/nys-oca-forms_1_22f67f.html

      OCA Official Form No.: 960 AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT TO HIPAA [This form has been approved by the New York State Department of Health] Patient Name Date of Birth Social Security Number Patient Address I, or my authorized representative, request that health information regarding my care and treatment be released as ...

    • [PDF File]REASONABLE ACCOMMODATION REQUEST (RAR) FORM

      https://info.5y1.org/nys-oca-forms_1_cd8389.html

      ¾ You may also fax the forms to (212) ... (NYS OCA Form No. 960) form and send it to: Mayor’s Office of Housing Recovery Operations Church St Station P.O. Box 468 New York, NY 10008-0468 ... The New York State Public Health Law protects information which reasonably could

    • [PDF File]DIRECT DEPOSIT FORM FOR NYS EMPLOYEES

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      direct deposit form for nys employees return completed form to your agency/department payroll or personnel office ac 2772 (rev 01/2021) page 1 of 2. section a: employee information (required) name (last, first, mi) nys emplid . n . last 4 ssn phone (area code + phone number) work email home address (street, city, state, zip code) section c:

    • [PDF File]NEW YORK STATE Unified Court System

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      The New York State Office of Court Administration (OCA) provides a New York Statewide criminal history record search (CHRS) for a fee of $95.00. You can submit a CHRS application in person at 25 Beaver Street, by mailing in a CHRS application form, or via our on-line ‘Direct Access’ program. The search criterion is strictly

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