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Get New York State Department Of Taxation And Finance Disability Income Exclusion New York State

Hown on your return Social security number For limits on exclusion, see instructions on back. Employer s name (also give payer s name, if other than employer) Date you retired (if after December 31, 1976). Also enter this date in the space provided on the Physician s statement below. Date of retirement Yourself Date of retirement Spouse Which column(s) to fill in Use Column A to enter your disability income amounts. If you are married and your spouse also received disability inc.

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