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IT-210 1(Bys:New York State Income Tax Bureau
1374 EMPLOYER'S RL TURN . PERSONAL INCOME TAX WITHHELD
TAX WITHHELD
PLEASE NOTE THE WITHHOLDING TAX PERIOD AND FILING DATE PRINTED BELOW.
If none. state reason on back
. .
PLEASE USE THE CARD WHICH CORRESPONDS WITH THE PERIOD COVERED BY YOUR RETURN.
LATE FILING AND PAYMENT INSTRUCTIONS
IF YOU DO NOT HAVE A CARD FOR THE PERIOD COVERED BY YOUR PAYMENT. CROSS OUT
INTEREST. AT 8'IN PER YEAR FOR LATE PAYMENT MUST BE
S
280 00
THE PRINTED DATES AND ENT . R THE O RRECT MONTHLY OR SEMI-MONTHLY PERIOD(S).
PAID. ADD PENALTY FOR LATE FILING OF 5% PER MONTH, NOT
REQUIRED FILING FREQUENCY
TO EXCEED 25% PLUS PENALTY OF 1/2% PER MONTH FOR LATE
INTEREST - PENALTY
PAYMENT UNLESS YOU SHOW REASONABLE CAUSE FOR LATE FILING
See Instructions
AND PAYMENT ON THE BACK OF THIS FORM. PENALTIES WILL BE
MONTHLY
ASSESSED IF YOU FAIL TO SHOW REASONABLE CAUSE
000 00
P RIOD . ROM
TO
DUE ON OR BEFORE
IDENTIFICATION NUMBER
TOTAL REMITTANCE - NYS Income Tax B
NOTE
PERIOD
05/01/74 - 05/31/74
06/15/74
13-2752467
CIT
$
280! 00
MAIL WITH REMITTANCE IN ONE OF
THE ENCLOSED ENVELOPES TO:
RE 410
F THIS IS A FINAL RETURN, CHECK APPLICAEL
BUSINESS
POST OFFICE BOX 229
ALBANY, N.Y. 12201
CITIZENS COMM SCIENCE LAW & FOOD SUPPLY
CORRECT NAME.
IF ONE OF THE ABOVE CONDITIONS APPLY:
ADDRESS AND
1230-YORK AVE&66 ST
1. WRITE THE WORDS "FINAL RETURN" AS
WH
IDENTIFICATION
"TAX WITHHELD" BOX IN UPPER RIGHT A
NUMBER IF INCORRECT.
NEW YORK HY
10021
2. GIVE EXPLANATION ON BACK OF CARD A'
ENTER ZIP CODE IF
NOT SHOWN.
FILE WITH PORMS IT-2102 AND IT-2103
WITHIN 30 DAYS
MONTHLY FILERS-DUE 15TH DAY OF FOLLOWING MONTH. EXCEPT DECEMBER RETURN DUE JANUARY 31
I CERTIFY THAT, EXCEPT FOR REQUIRED CORRECTIONS FOR PRIOR PERIODSIN 1974 THIS RETURN IS CORREC
FILING
SEMI-MONTHLY FILERS.DUE THIRD BANKING DAY AFTER 15TH AND END OF EACH MONTH. EXCEPT
DATES
RETURN FOR LAST HALF OF DECEMBER IS DUE JANUARY 31.
SIGNATURE _
CC-26960
DD-M 17189
TIT
Executive Secretary
DATE
6. 14 . 74
C. ID
1-2
EMPLOYER NUMBER
NAMEC CL PERIOD
TAX WITHHELD
TOTAL REMITTANCE
ALT. PERIOD
TRANSACTION NO.
3-13
14.15 17 18-20
ALT. TAX WITHHELD ALT.TOTAL REMITTANCE DATE BECD. F
21-29
30-38
39-47
48-56
57-60
62-68
69-76
stedw/docs/jrey0227

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