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NYS TAX DEPARTMENT

TAXPAYER ASSISTANCE BUREAU

W A HARRIMAN CAMPUS

ALBANY NY 12227

Part 1 - Jurisdictions That Do Not Impose the Local Tax

Complete Part 1 for each locality where you made sales of eligible clothing and footwear that cost less than $110. If you made sales of

clothing and footwear that cost $110 or more in any of these localities, report those sales on the appropriate reporting lines on your Monthly

Schedule K, Monthly Schedule K (VC) or Quarterly Schedule K. (For sales of eligible clothing made in other localities, complete Part 2.)

This part must be completed even though no tax is due on these sales.

Column A

Column B

Column C

Column D

Taxing Jurisdiction

Jurisdiction Code

Sales Eligible for Exemption

Purchases Eligible for

(to the nearest dollar)

Exemption

(to nearest dollar)

Broome County

X0313

.00

Chatauqua County

X0607

.00

Chenango County (outside the following)

X0805

.00

Norwich (city)

X0844

.00

Columbia County

X1003

.00

Cortland County

X1122

.00

Delaware County

X1202

.00

Greene County

X1903

.00

JeffersonCounty

X2207

.00

Madison County (outside the following)

X2582

.00

Oneida (city)

Report sales made in the city of Oneida, in Part 2.

Oswego County (outside the following)

X3599

.00

Fulton (city)

X3537

.00

Oswego (city)

Report sales made in the city of Oswego, in Part 2.

Rensselaer County

X3875

.00

Rockland County

X3906

.00

Schuyler County

X4407

.00

Suffolk County

X4718

.00

Sullivan County

X4817

.00

Tioga County

X4903

.00

New York City

X8009

.00

Column totals for all jurisdictions in Part 1:

.00

OP-400 (Rev 3/01)

Page 2 of 4

Schedule H - Report Of Clothing And Footwear Eligible For Exemption - New York State Department Of Taxation And Finance Page 2

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