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This version of the form is not currently in use and is provided for reference only. Download this version of
Form EOSB-210.5
for the current year.
Form EOSB-210.5 Volunteer Firefighter Enhanced Cancer Disability Benefits Program Attestation / Proof of Benefits - New York
What Is Form EOSB-210.5?
This is a legal form that was released by the New York State Division of Homeland Security & Emergency Services - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the form EOSB-210.5 for?A: The form EOSB-210.5 is for the Volunteer Firefighter Enhanced Cancer Disability Benefits Program Attestation/Proof of Benefits in New York.
Q: What does the form EOSB-210.5 verify?A: The form EOSB-210.5 verifies the benefits received by volunteer firefighters under the Enhanced Cancer Disability Benefits Program in New York.
Q: Who is required to complete form EOSB-210.5?A: Volunteer firefighters in New York who receive benefits under the Enhanced Cancer Disability Benefits Program are required to complete form EOSB-210.5.
Q: What information is needed to complete form EOSB-210.5?A: To complete form EOSB-210.5, you will need to provide information about the benefits you have received and the periods for which you received them.
Q: Are there any deadlines for submitting form EOSB-210.5?A: Yes, there are deadlines for submitting form EOSB-210.5. It is recommended to submit the form within 90 days of receiving benefits or as stated in the instructions.
Q: Is there a fee for submitting form EOSB-210.5?A: No, there is no fee for submitting form EOSB-210.5.
Q: What should I do if I need assistance with form EOSB-210.5?A: If you need assistance with form EOSB-210.5, you can contact your local fire department or the New York State Workers' Compensation Board for guidance.
Form Details:
- Released on November 1, 2020;
- The latest edition provided by the New York State Division of Homeland Security & Emergency Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form EOSB-210.5 by clicking the link below or browse more documents and templates provided by the New York State Division of Homeland Security & Emergency Services.
Download Form EOSB-210.5 Volunteer Firefighter Enhanced Cancer Disability Benefits Program Attestation / Proof of Benefits - New York
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