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ions (but not those of NYS or its local governments) 21 Public employee 414(h) retirement contributions from your wage s tatements (see page 16) 22 New York's 529 college savings program distributions (see 23 Other (Form 1T-225, line 9) 24 Add lines 19 through 23 New York subtractions (see page 17) 2
1615964 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
ons (but not those of NYS or its local governments) 21 Public employee 414(h) retirement contributions from your 4lage statements (sea Page 16) 22 New York's 529 college savings program distributions 23 Other (Form IT-225, line 9) 24 Add lines 19 through 23 New York subtractions (see page 17) 25 Taxabl
1616657 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
obligations (but not those of NYS or its local governments) 21 Public employee 414(h) retirement contributions from yo s tatements (seepage 16) 22 New York's 529 college savings program distributions 23 Other (Form 1T-225, line 9) 24 Add lines 19 through 23 New York subtractions (see page 17) 25 Taxabl
1540837 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
t not those of NYS or its local governments) 21 Public employee 4140) retirement contributions from your wage and tax statements (see page 16) 22 New York's 529 college savings program distributions (see page 16) 23 Other (Form IT-225, line 9) 24 Add lines 19 through 23 New York subtractions (see Pag
EROs must complete Part C prior to transmitting electronically filed income tax returns (Forms IT-201, 11-201-X. IT-203, IT-20&X.17214, NYC-208, and NYC-210). Both the paid preparer and the ERO are required to sign Part C. However, if an individual performs as both the paid preparer and the ERO, he or
Entities connected to both New York and NYC-210

United States
LOCATION
New York City
LOCATION
New York State
LOCATIONMaria Farmer
PERSON
NEW YORK NY
LOCATION
U.S. Treasury
ORGANIZATION
Joi Ito
PERSON
the Internal Revenue Service
ORGANIZATIONChang
PERSONUtilities
ORGANIZATION
York City
LOCATION
FinCEN
ORGANIZATIONYonkers
LOCATIONSpouse
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONNY State
ORGANIZATIONFirst Installment
ORGANIZATION
Empire State
LOCATIONTHE NY TAX DEPT
ORGANIZATIONBreast Cancer Research Fund
ORGANIZATION