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STATE OF NEW YORK WORKERS' COMPENSATION BOARD DISABILITY BENEFITS BUREAU 100 BROADWAY-MENANDS ALBANY, NY. 12241 0005 NOTICE AND PROOF OF CLAIM FOR DISABILITY BENEFITS BY UNEMPLOYED CLAIMANT IMPORTANT:
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The State of New York refers to the government entity that governs the State of New York, which is one of the 50 states of the United States of America.
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