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Get New York State Department Of Taxation And Finance For Office Use Only Attach Label, Or Print Or

Nter your social security number(s) in the boxes to the right. Your first name and middle initial Your last name (for a joint claim, enter spouse s name on line below) Your social security number Spouse s first name and middle initial Spouse s last name Spouse s social security number Current mailing address (number and street or rural route) City, village, or post office State Apartment number ZIP code NY State county of residence Qualifying social security number if differen.

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