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Get NY DOH-4444 2010-2024

_______________ Social Security Number: _______________________ Address: _________________________________________________________________________________________ City: _______________________________________ State: _______________________ Zip Code: _______________ Complete the information below only if you have no other way to document your income. All of the boxes below must be checked and all questions answered. Failure to complete this form may result in denial of your application. I get pa.

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