Guide: Filling out an Employee Leasing Form

Laura DiNitto
|
213 steps
|
25 minutes

Formstack

Talispoint

Osha

Google

1

Navigate to [https://nixercomp.formstack.com/forms/employee_leasing_of_greater_new_york_nci_cdr_system_portal_v080523](https://nixercomp.formstack.com/forms/employee_leasing_of_greater_new_york_nci_cdr_system_portal_v080523)

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Click this button field.

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Click the "I Acknowledge Understanding" field.

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Click "Next"

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Click the "Yes" field.

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Click the "No" field.

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Click "Next"

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Click the "No" field.

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Click the "Yes" field.

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Click "Next"

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Click "Host Employer Company Information The Legal Business Entity is the entity invoiced by the staffing company and responsible for the day-to-day di..."

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click this text field.

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Click this text field.

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Type "Ontrac"

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Click this telephone field.

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In a new tab, navigate to [https://www.google.com/search?q=ontrac+headquarters&rlz=1C1GCEU_enUS993US993&oq=ontrac+headquarters&gs_lcrp=EgZjaHJvbWUqCggAEAAY4wIYgAQyCggAEAAY4wIYgAQyDQgBEC4YrwEYxwEYgAQyBwgCEAAYgAQyCAgDEAAYFhgeMgoIBBAAGIYDGIoFMgoIBRAAGIYDGIoFMgoIBhAAGIYDGIoFMgoIBxAAGIYDGIoF0gEIMzg3N2owajeoAgCwAgA&sourceid=chrome&ie=UTF-8](https://www.google.com/search?q=ontrac+headquarters&rlz=1C1GCEU_enUS993US993&oq=ontrac+headquarters&gs_lcrp=EgZjaHJvbWUqCggAEAAY4wIYgAQyCggAEAAY4wIYgAQyDQgBEC4YrwEYxwEYgAQyBwgCEAAYgAQyCAgDEAAYFhgeMgoIBBAAGIYDGIoFMgoIBRAAGIYDGIoFMgoIBhAAGIYDGIoFMgoIBxAAGIYDGIoF0gEIMzg3N2owajeoAgCwAgA&sourceid=chrome&ie=UTF-8)

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Click here.

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Click "(302) 246-7136"

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Press [[ctrl]] + [[c]]

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Click this telephone field.

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Press [[ctrl]] + [[v]]

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Click "Yes"

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Right-click "Support - OnTrac"

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click the "Please enter at least one thoughtful sentence describing this company's operations (25 Characters Minimum)" field.

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Click the "Please enter at least one thoughtful sentence describing this company's operations (25 Characters Minimum)" field.

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Press [[ctrl]] + [[v]]

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Click "Conduct OSHA Establishment Search"

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Click "x"

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Click the "Establishment" field.

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Type "Ontrac"

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Click "Search"

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Click "Ontrac Logistics, Inc."

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Click "1519299.015"

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Click the "Yes" field.

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Click "No Serious Violations"

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Click the "No" field.

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Click here.

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Click the "Yes" field.

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Click "Entity Not Found"

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Click "Violations Resulting in Injury"

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Click "No Serious Violations"

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Click "Next"

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Click "Enter the Host Employer Jobsite Street Address (Not a PO Box)"

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Press [[ctrl]] + [[v]]

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click this text field.

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Click this text field.

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Click this text field.

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Type

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Click this text field.

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Click this text field.

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Click this dropdown.

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Click here.

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Click "Same as the Host Employer Final Product or Service"

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Press [[ctrl]] + [[v]]

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Type " [[Backspace]]"

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Type " [[Backspace]]"

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Click "Next"

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Click "Previous"

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Click "Same as the Host Employer Final Product or Service"

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Click the "Please enter at least one thoughtful sentence describing this company's jobsite operations (25 characters minimum)." field.

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Press [[ctrl]] + [[v]]

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Click "Next"

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click this dropdown.

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Click this text field.

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Type " [[End]] [[NumLock]] 22182"

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Click "Next"

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Click the "Enter Only One Job/Position Title Per Request" field.

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Click the "Enter Only One Job/Position Title Per Request" field.

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Click the "Enter Only One Job/Position Title Per Request" field.

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Press [[ctrl]] + [[v]]

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Click the "Please enter at least one thoughtful sentence describing the Temporary Employes's Job Summary of the Duties/Tasks the Employee(s) will be performing at/or from this job-site location (25 characters minimum)." field.

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Press [[ctrl]] + [[v]]

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Click here.

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Click "Office Clerical in Nature"

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Click "No"

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Click the "No" field.

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Click "Next"

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Click this number field.

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Type "40"

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Click this number field.

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Type "15.50"

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Click this number field.

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Type "5 [[tab]]"

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Click "Forecasted Average Hours Per Day/Employee"

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Click this number field.

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Type "8"

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Click this number field.

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Type "5 [[tab]] [[tab]] 130 [[tab]]"

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Click this number field.

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Click this number field.

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Click "Next"

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Click this image.

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Click here.

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Click this image.

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Click "7"

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Click this dropdown.

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Click "Confirm Job Assignment Term"

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Click "Next"

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Click this number field.

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Click this number field.

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Click this number field.

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Click "Confirmed"

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Click "Next"

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Click the "YES" field.

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Click the "DOES NOT EXIST" field.

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Click "YES"

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Click "24-Hour Host Employer Jobsite Operations"

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Click here.

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Click "YES"

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Click the "YES" field.

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Click the "YES" field.

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Click "Job Assignment Risk Management Supplementals Carefully answer the following underwriting questions regarding the job assignment to identify req..."

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Click "Powered Industrial Truck (PIT) Operation"

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Click "Next"

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Click "Previous"

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Click the "NONE REQUIRED" field.

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Click "Next"

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Click this number field.

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Click the "No" field.

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Click "Next"

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Click "Body Protection"

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Click "Vests"

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Click "Foot and/or Leg Protection"

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Click "Safety Shoes"

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Click "Next"

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Click this number field.

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Type "50 [[CapsLock]] [[CapsLock]] [[tab]]"

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Double-click this number field.

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Type "75"

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Right-click here.

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Click here.

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Double-click this number field.

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Type " [[Backspace]] 50"

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Click this dropdown.

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Click the "Separate item descriptions with commas (,)" field.

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Type "boxes, packages, packaging supplies"

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Click "Over the Shoulder (OTS) Lifting Frequency"

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Click this dropdown.

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Click this dropdown.

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Click this dropdown.

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Click the "No" field.

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Click "No"

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Click "Next"

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Click "Claims Kit Contact Acknowledgement"

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Click "Claims Kit Contact Acknowledgement"

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Click "Next"

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Click this text field.

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Press [[ctrl]] + [[v]]

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Press [[ctrl]] + [[v]]

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Click this text field.

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Click this text field.

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Click this text field.

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Type "e"

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Click this text field.

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Type "Operations manager [[tab]] 7037619030"

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Click this telephone field.

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Press [[ctrl]] + [[c]]

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Click this telephone field.

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Press [[ctrl]] + [[v]]

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Click this email field.

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Press [[ctrl]] + [[v]]

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Click "Jobsite Supervisor"

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Click "Jobsite Supervisor Phone"

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Click "Next"

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Click the "Same as Jobsite Supervisor or Contact" field.

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Click "Next"

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Click this image.

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Click this button.

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Click "Quick Search"

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Click "Address City State Zip You must enter a valid zip code or city and state."

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click this text field.

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Press [[ctrl]] + [[v]]

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Click this text field.

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Press [[ctrl]] + [[v]]

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Type " [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]] [[left]]"

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Click this text field.

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Click "Enter Address Address City State Zip You must enter a valid zip code or city and state. Networks: StrataCare Network Algori..."

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Click this button.

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Click this button.

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Click this button.

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Click "Next"

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Click this button field.

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Click "Next"

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Click "Previous"

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Click "Next"

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Click this field.

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Click "Next"

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Click "Next"

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Click "Next"

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Click "Acknowledge"

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Click "Submission Confirmation & Fraud Acknowledgement Workers' Compensation Policy Period Effective Date and Time 08/05/2023 12:01 AM Normal E..."

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Click here.

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Click this button.