We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Ac 1171 Fillable

Get Ac 1171 Fillable

SEE INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING AC 1171 Rev. 10/96 STATE OF NEW YORK 1 Originating Agency Orig. Agency Code NYS Dept. of Environmental Conservation Payment Date MM DD YY Interest Eligible Y/N 09000 No OSC Use Only Additional 2 Payee ID Voucher No. STATE AID VOUCHER Liability Date 3 Zip Code Route MM DD YY Payee Amount 4 Payee Name Limit to 30 spaces IRS Code IRS Amount Stat. Agency Code NYS Dept. of Environmental Conservation P.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Ac 1171 Fillable online

Filling out the Ac 1171 Fillable form online can be a straightforward process when guided step-by-step. This user-friendly guide will provide you with clear instructions to ensure your submission is accurate and complete.

Follow the steps to successfully complete the Ac 1171 Fillable form.

  1. Press the ‘Get Form’ button to obtain the Ac 1171 Fillable document and open it in your preferred online editor.
  2. In the 'Originating Agency' section, enter the originating agency code, payment date, and indicate if the interest is eligible by marking 'Y' for yes or 'N' for no.
  3. Fill in the 'Payee ID' with the relevant identification information and provide the voucher number and liability date.
  4. Complete the 'Zip Code' and 'Payee Name' fields. Note that the payee name should be limited to 30 characters.
  5. List the 'IRS Code' and the corresponding 'IRS Amount' as required. Repeat for any additional names or amounts if applicable.
  6. Provide the 'Reference/Invoice Number' and 'Reference/Invoice Date', ensuring all entries are within the specified limits.
  7. In the 'Description of Charges' section, enter the details of the charges incurred. If necessary, reference any attached sheets for more information.
  8. Complete the 'Total' amount due. Ensure that this reflects the accurate total for all charges listed.
  9. Sign and date the 'Payee Certification' section in ink, certifying that the expenditures are correct and the claim is valid.
  10. If required, complete any additional information, and if space is insufficient, use the continuation sheet (Form AC 1172).
  11. Finally, save your changes, and download, print, or share the filled form as necessary.

Start filling out your Ac 1171 Fillable form online today to ensure your expenses are processed efficiently.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Forms for State Agencies and Employees | Office of...
AC 1782‑S, Bureau of Contracts Authorized Signature Form, Fillable PDF. AC 3268‑S...
Learn more
AGRI 1171 - Ag Technology - Acalog ACMSâ„¢
Lincoln Campus Catering Menu · Policies and Procedures · Fillable Catering Form. Close...
Learn more
AMAZON.COM TRUCKLOAD - Department Store...
Ambient Weather WS-1171 Wireless Advanced WeatherStation with Temperature, Dew Point...
Learn more

Related links form

Response To The Comments Of The Florida Public - Florida State ... Dependent Care Reimbursement Form - Fordham University Comments Of The Florida Prosecuting Attorneys Association - Law Fsu OP-SC07-1851 - Florida State University College Of Law - Law Fsu

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Ac 1171 Fillable
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232