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Get NY OSC AC 1171 1996-2024

AC 1171 Rev 10/96 STATE OF NEW YORK Originating Agency Payment Date MM DD / YY Voucher No. Interest Eligible Y/N Orig. Agency Code STATE AID VOUCHER OSC Use Only Liability Date Payee ID Additional 3 Zip Code Route Payee Amount MIR Date MM DD YY 4 Payee Name Limit to 30 spaces IRS Code Stat. Agency Code STATE AID VOUCHER OSC Use Only Liability Date Payee ID Additional 3 Zip Code Route Payee Amount MIR Date MM DD YY 4 Payee Name Limit to 30 spaces IRS Code Stat. Type Statistic Address Limit to 30 .

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