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instructions) 2 Empire State child credit (from Form IT-201, fine 63) 3 NYS/NYC child and dependent care credit (from Form IT-201, line 64) 4 NY State earned income credit (EIC) (from Form IT-201, line 65) 5 NY State noncustodial parent EIC (from Form IT-201, fine 66) 6 Real property tax credit
AMOUNT OF AUTHORIZED DEBIT: FINANCIAL INSTITUTION ROUTING NUMBER: FINANCIAL INSTITUTION ACCOUNT NUMBER: Part A - Declaration and authorization of Taxpayer for Forms NYC-202, NYC-202S, NYC-EXT or NYC-5UBT1 Under penalty Unincorporated knowledge and electronically Internal Revenue Business Tax New York City designated financ
instructions) 2 Empire State child credit (from Form IT-201, fine 63) 3 NYS/NYC child and dependent care credit (from Form IT-201, fine 64) 4 NY State earned income credit (EIC) (from Form IT-201, line 65) 5 NY State noncustodial parent EIC (from Form IT-201, fine 66) 6 Real property tax credit
AMOUNT OF AUTHORIZED DEBIT: FINANCIAL INSTITUTION ROUTING NUMBER: FINANCIAL INSTITUTION ACCOUNT NUMBER: Part A - Declaration and authorization of Taxpayer for Forms NYC-202, NYC-202S, NYC-EXT or NYC-5UBT1 Under penalty Unincorporated knowledge and electronically Internal Revenue Business Tax New York City designated financ
N) ***** 9816 2 Empire State child credit (from Form IT-201, fine 63) 3 NYS/NYC child and dependent care credit (from Form IT-201, fine 64) 4 NY State earned income credit (EIC) (from Form IT-201, Nne 65) 5 NY State noncustodial parent EIC (from Form IT-201, fine 66) 6 Real property tax credit (
AMOUNT OF AUTHORIZED DEBIT: FINANCIAL INSTITUTION ROUTING NUMBER: FINANCIAL INSTITUTION ACCOUNT NUMBER: Part A - Declaration and authorization of Taxpayer for Forms NYC-202, NYC-202S, NYC-EXT or NYC-5UBTI Under penalty Unincorporated knowledge and electronically Internal Revenue Business Tax New York City designated financ
Entities connected to both NY State and Taxpayer for Forms NYC-202, NYC-202S

New York State
LOCATION
New York
LOCATION
the Internal Revenue Service
ORGANIZATION
United States
LOCATIONINTERNAL REVENUE SERVICE CENTER
ORGANIZATIONFirst Installment
ORGANIZATION
Empire State
LOCATIONBreast Cancer Research Fund
ORGANIZATIONMaria Farmer
PERSONSpouse
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATIONNYC-210
ORGANIZATIONNY City
LOCATIONthe New York State Department of Taxation and Finance
ORGANIZATIONYonkers
LOCATIONPreparer
ORGANIZATIONFiler
PERSON