the New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION4
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saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
ealth Education 60i .00 60) Veterans Remembrance 60) .00 60k Homeless Veterans 60k .00 601 Mental Illness AntiStigrna Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o .00 60 Total voluntary contributions (add tines 60a through 60o) 61 Total New Y
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
ealth Education 60i .00 60) Veterans Remembrance 60) .00 60k Homeless Veterans 60k .00 601 Mental Illness Anti-Stigma Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o .00 60 Total voluntary contributions (add tines 60a through 60o) 61 Total New Y
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
ealth Education 60i .00 60) Veterans Remembrance 60) .00 60k Homeless Veterans 60k .00 60I Mental Illness Anti-Stigma Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o 00 60 Total voluntary contributions (add fines 60a through 60o) 61 Total Now Yo
eturn and any authorized payment transaction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I authorize the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2015 electroni
en Hearth Education 60i 00 60) Veterans Remembrance 60) 00 60k Homeless Veterans 60k 00 601 Mental Illness AntiStigrna Fund 601 00 60m Women's Cancers Education and Prevention Fund 60m 00 60 Total voluntary contributions (add fines 60a through 60m) too 61 Total New York State, New York City, Yonkers, and sales or use taxe
Entities connected to both the New York State Tax Department and Women's Cancers Education and Prevention Fund

New York State
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONYonkers
LOCATION
New York
LOCATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATIONMaria Farmer
PERSONPreparer
ORGANIZATIONInternational ACH Transactions
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATION
United States
LOCATIONSpouse
ORGANIZATIONNY City
LOCATIONNYC-210
ORGANIZATION
NEW YORK NY
LOCATION
New York City
LOCATION
the Internal Revenue Service
ORGANIZATIONBreast Cancer Research Fund
ORGANIZATIONNY State
ORGANIZATION
Empire State
LOCATION