Form Tr-620.1 - Seasonal Exception Worksheet For Form Ct-222
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1
2Office of Processing and Taxpayer Services
W A Harriman Campus
Albany NY 12227
Seasonal Exception Worksheet for Form CT-222
Taxpayer’s name:
Employer identification number (EIN):
Telephone number: (
)
Contact name:
Contact title:
/
/
Tax period ended:
Mark an X in the applicable box(es) State:
MTA surcharge:
A
B
C
D
E
F
G
Month of
Monthly allocated
Monthly allocated
Monthly allocated
Monthly allocated
Monthly tax
Monthly other
tax year
amount for the
amount for the tax
amount for the tax
amount for the tax
credits for the
taxes for the
tax year of penalty *
year one year prior to penalty*
year one year prior to penalty*
year one year prior to penalty*
year of penalty
year of penalty
(mm/yy)
1
month:
st
2
month:
nd
3
month:
rd
4
month:
th
5
month:
th
6
month:
th
7
th
month:
8
month:
th
9
th
month:
10
month:
th
11
month:
th
12
month:
th
Of your 12-month liability period, provide the consecutive 6-month period in which you earned seventy percent or more of your income.
Start month:
End month:
Telephone number: (
)
/
/
Signature of authorized person:
Date:
TR-620.1 (7/11)
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