Form Ra 22 1 is a form used by employers to report wages and tip income paid to employees. This form is used to report information for each employee on the total amount of wages and tips received, as well as the federal income tax withheld from those payments. This form must be filed every year with the IRS. In order to complete this form accurately, you will need information about each employee's wages and tips for the year. You can find more information about Form Ra 22 1 on the IRS website.
| Question | Answer |
|---|---|
| Form Name | Form Ra 22 1 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | NY, New_York, nyshcr, non employment re employment certificate |
State of New York |
Gertz Plaza |
Division of Housing and Community Renewal |
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Office of Rent Administration |
Jamaica, NY 11433 |
Web Site: www.nyshcr.org |
(718) |
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Tenant Affirmation of
Docket Number:
Mailing Address of Tenant: |
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Mailing Address of Owner/Managing Agent: |
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Name: |
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Name: |
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Number/Street: |
Apt. No.: |
Number/Street: |
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City, |
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City, |
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State, Zip Code: |
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State, Zip Code: |
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Telephone No. (If None, put None): |
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Telephone No. (If None, put None): |
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Subject Building (if different from tenant's mailing address):
Number and Street |
Apartment Number |
City, State, Zip Code |
Instructions to Tenant:
You may file this form to request compliance proceedings be initiated if the owner has failed to comply with an order within thirty (30) days after the issue date of the Order.
To request the initiation of compliance proceedings, you should:
1.Wait thirty (30) days after the Order is issued;
2.Complete this Affirmation of
3.Attach a complete copy of the Order that has not been complied with; and
4.Mail this form at least thirty (30) days after the issue date of the Order. Please attach a copy of the Order.
DO NOT use this form to complain about conditions which are not listed on the Order. A new complaint form must be filed for those conditions not listed on the Order.
Affirmation
I, |
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, hereby affirm that the Owner has not complied with the Order issued on |
(Print Name)
by the Rent Administrator. The owner has failed to:
All other conditions cited on the Order which are not listed above have been corrected.
/ /
Date |
Signature of Tenant |