Form Nys-1-Mn Retun Of Tax Withheld Nys

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Scroll down to complete Form NYS-1-MN
Tab between entry areas and click on the check boxes to
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of paper, or two-sided printing.
Scroll down to complete the back of Form NYS-1-MN
Cut on the dotted lines before filing this form.
New York State Department of Taxation and Finance
Please file the original form
Return of Tax Withheld
(not a copy) and print or
type in black ink, not pencil.
Withholding identification number
1 New York State
tax withheld
2 New York City
tax withheld
legal name:
3 Yonkers
tax withheld
4 Total withheld
A Last payroll date – Enter date of last
( add lines 1, 2, & 3 )
payroll covered by this return (MMDDYY)
5 Credit
B If you permanently ceased paying wages,
enter date of final payroll (MMDDYY)
6 Total tax due
C Mark an X in the box for additional payment
( line 4 minus line 5 )
I certify that this information is to the best of my knowledge and belief true, correct, and complete.
Taxpayer’s signature
Taxpayer’s name
( print or type )
Telephone number
Mark X if new
For office
employer or address
( see back )
use only
Received date


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