Section 32 Electronic Signature {C-32E}

C-32E - SECTION 32 - ELECTRONIC SIGNATURE. This form is used for the purpose of confirming the use of electronic signatures in signing a Section 32 Agreement with the Workers' Compensation Board in the State of New York. The form is completed by the insurance carrier, self-insured employer, or third-party administrator, who affirms that they have signed the attached Section 32 Agreement electronically. The form includes details such as the name of the claimant, the WCB case number(s), and the date(s) of the accident. The specific electronic signature method used, such as DocuSign or Adobe Sign, is described. The undersigned individual affirms their authority to bind the insurance carrier or self-insured employer to the electronically signed Section 32 Agreements. The form requires the signature, printed name, title, email, phone number, and date of the individual completing the form. www.FormsWorkflow.com