Download Ga 4 New York Template in PDF Open Ga 4 New York Editor Now

Download Ga 4 New York Template in PDF

The Quarterly Unified Employer Assessment Municipal Self-Insurers Remittance Form, commonly known as the GA-4 form, is a document required by the State of New York's Workers' Compensation Board. This form must be completed by active municipal self-insured employers each quarter and submitted with payment within thirty days after the quarter ends. It serves to report payroll and calculate assessments for workers' compensation coverage.

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Similar forms

  • Form 941: This is the Employer's Quarterly Federal Tax Return. Similar to the GA-4, it requires employers to report payroll information quarterly, including the taxes withheld from employee wages. Both forms serve to ensure compliance with tax obligations.

  • NYS-45: This is the New York State Quarterly Combined Withholding, Wage Reporting and Unemployment Insurance Return. Like the GA-4, it collects payroll data and must be submitted quarterly, helping to track employee remuneration and contributions to unemployment insurance.

  • Form 990: Nonprofit organizations use this form to report financial information, including compensation for employees. Similar to the GA-4, it ensures transparency and accountability in payroll reporting.

  • W-2 Forms: Employers issue W-2 forms to report annual wages and taxes withheld for each employee. While the GA-4 is quarterly, both documents are essential for accurate payroll reporting and tax compliance.

  • Form 1099: This form is used to report various types of income other than wages, salaries, and tips. Like the GA-4, it requires accurate reporting of income paid to non-employees, ensuring compliance with tax regulations.

  • Payroll Tax Returns: These returns are filed to report payroll taxes owed by employers. Similar to the GA-4, they require detailed payroll information to ensure that tax obligations are met.

  • State Unemployment Insurance (SUI) Returns: Employers file these returns to report wages paid and calculate unemployment insurance contributions. Like the GA-4, these forms are essential for compliance with state regulations.

  • Workers' Compensation Insurance Reports: These reports track claims and payroll data for workers' compensation insurance. Similar to the GA-4, they help ensure that employers are meeting their obligations regarding employee safety and compensation.

  • Form 7004: This is an application for an automatic extension of time to file certain business tax returns. While it serves a different purpose, both forms require accurate reporting of financial data related to payroll and taxes.

  • Form 1095-C: This form is used by applicable large employers to report health insurance coverage offered to employees. Similar to the GA-4, it ensures compliance with healthcare regulations and tracks employee benefits.

Guide to Filling Out Ga 4 New York

Completing the GA-4 New York form is an essential task for municipal self-insured employers. This form must be filled out accurately to ensure compliance with state regulations. Below are the steps to guide you through the process of filling out the form.

  1. Obtain the Form: Download the GA-4 form from the New York State Workers' Compensation Board website or request a physical copy if necessary.
  2. Municipal Self-Insurer Information: Fill in your WCB Identification Number (W Number) and the full legal name of your municipal self-insured employer.
  3. FEIN: Enter the Federal Employer Identification Number for your municipal self-insurer.
  4. Mailing Address: Provide the complete mailing address, including the number and street, city, state, and zip code.
  5. Reporting Period: Indicate the calendar year and the quarter ending for which you are reporting.
  6. Basis for Assessment: Report the payroll class code, description, and total quarterly payroll for each category (e.g., school district employees and all other municipal employees).
  7. Calculate Loss Costs: Multiply the total payroll by the loss cost per hundred dollars of payroll, then divide by 100.
  8. Subtotal Payroll: Sum up the total payroll reported and account for any excluded payroll not subject to assessment.
  9. Total Payroll: Add the subtotal payroll and any excluded payroll to get the total payroll amount.
  10. Total Loss Cost: Calculate the total loss cost based on the payroll and loss cost rates provided.
  11. Assessment Rate: Apply the assessment rate (13.8%) to determine the total assessment due.
  12. Certification: Sign the form, include your title, printed name, date, and phone number to certify the accuracy of the information provided.

Once you have completed the form, ensure that it is submitted along with the payment within thirty days of the end of the quarter. You can email the completed form to the Workers' Compensation Board or mail it along with your check to the specified address. Following these steps will help maintain compliance and avoid potential penalties.