Form It-260.1 - Change Of Resident Status - Special Accruals (Page 2 of 2) in pdf

IT-260.1 (9/99) (back)

IV.

Standby letter of credit:

Issuer or confirming bank

Amount

Expiration date

Attached and made part of this agreement is the irrevocable standby letter of credit made payable to the New York State

Department of Taxation and Finance.

Form IT-2102-G, Report of Certain Gambling Winnings :

Attached and made part of this agreement is a copy of completed Form IT-2102-G, Report of Certain Gambling

Winnings, which shows that taxes were withheld on the lottery payments.

I agree that (1) I will include in my New York personal income tax returns in subsequent

Now, therefore,

I had not changed my

taxable years (or periods) all income and gain accrued prior to my change of residence, as if

resident status and will pay the tax thereon when due; (2) the period of limitation within which tax may be assessed, set

forth in Tax law section 683, is hereby extended as provided by paragraph (2) of subsection (c) of such section, and

hereby agree that the tax due may be assessed for any taxable year (or periods) at any time within 3 years after the tax

return relating to the last taxable year during which income or gain accruing prior to my change of residence is actually

I have

received has been filed; and (3) if the New York State Department of Taxation and Finance determines (a) that

failed to include in my New York personal income tax return for any taxable year (or period) any item of income or gain

that is required to be included therein under the terms of this agreement, or to pay any tax required to be paid, or

(b) that the security filed herewith has or will become inadequate to properly secure payment of the tax, the full amount

of income which is accruable under sections 639(a), 639(e), 1307(b) and 1307(d) of the Tax law shall be accrued to the

portion of the taxable year prior to the change of residence and the additional tax for such period, as recomputed, shall

become due immediately. If such tax is not paid within 30 days after notice of such determination described in (a) above

has been mailed to me by ordinary mail, or if the security that has been determined, as described in (b) above, to be

inadequate to secure payment of the tax is not replaced with adequate security acceptable to the department within 30

days after notice of such determination has been mailed to me by ordinary mail, the New York State Department of

Taxation and Finance may sell, assign, transfer, withdraw or otherwise dispose of said security and apply the proceeds

to any unpaid portion of the tax deferred by reason of the election and any interest and penalties due thereon. The

balance of such proceeds, if any, shall be paid to me.

The above described security is deposited with the understanding that: (1) in case no disposition is made

thereof under the terms of this agreement, such security will be returned to me at such time as the department

determines it is no longer needed as security by reason of the full or partial payment of the tax deferred as a result of

the election under sections 639(d), 639(e), 1307(b) and 1307(d); and (2) any interest accruing on said security shall

belong to me; and (3) in the case of certificated bonds, in coupon form, the coupons will be detached and forwarded to

me as they become due.

Signature of taxpayer

Date

Spouse’s signature

(if joint return)

IT-260.1 (9/99)

Form It-260.1 - Change Of Resident Status - Special Accruals Page 2