It 370 V Form – Fill Out and Use This PDF

New York State Department of Taxation and Finance

Payment Voucher and Instructions for Form IT-370 Filed Online

Automatic Extension of Time to File for Individuals

IT-370-V

Who must use this form

You must submit this voucher with your payment if you file a balance due extension online using Form IT-370, Application for Automatic Extension of Time to File. If you pay by credit card, you do not file this form.

Separate extension requests must be submitted for a husband and wife who file separate returns.

When to file

You must pay the amount you owe on or before April 15, 2005, to avoid interest and penalty. For fiscal year filers, the filing deadline is the 15th day of the fourth month following the close of your tax year.

Privacy notification

The Commissioner of Taxation and Finance may collect and maintain personal information pursuant to the New York State Tax Law, including but not limited to, sections 171, 171-a, 287, 308, 429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and may require disclosure of social security numbers pursuant to

42 USC 405(c)(2)(C)(i).

This information will be used to determine and administer tax liabilities and, when authorized by law, for certain tax offset and exchange of tax information programs as well as for any other lawful purpose.

Information concerning quarterly wages paid to employees is provided to certain state agencies for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain employment and training programs and other purposes authorized by law.

Failure to provide the required information may subject you to civil or criminal penalties, or both, under the Tax Law.

Mailing instructions

Enclose a check or money order payable to New York State Income Tax for the full amount you owe and write your social security number and 2004 Income Tax on it.

Detach and mail this voucher along with your payment to:

EXTENSION REQUEST

PO BOX 4125

BINGHAMTON NY 13902-4125

Private delivery services — If you choose, you may use a private delivery service, instead of the U.S. Postal Service, to file your return and pay tax. However, if, at a later date, you need to establish the date you filed your return or paid your tax, you cannot use the date recorded by a private delivery service unless you used a delivery service that has been designated by the U.S. Secretary of the Treasury or the Commissioner of Taxation and Finance. (Currently designated delivery services are listed in Publication 55, Designated Private Delivery Services. See Need help? in these instructions for information on ordering forms and publications.) If you have used a designated private delivery service and need to establish the date you filed your return, contact that private delivery service for instructions on how to obtain written proof of the date your return was given to the delivery service for delivery. If you use any private delivery service, whether it is a designated service or not, address your return to: NYS Tax Processing, 33 Lewis Rd., Binghamton NY 13905-1040.

This information is maintained by the Director of Records Management and Data Entry, NYS Tax Department, W A Harriman Campus, Albany NY 12227; telephone 1 800 225-5829. From areas outside the United States and outside Canada, call (518) 485-6800.

Need help?

Internet access: www.nystax.gov

Access our Answer Center for answers to frequently-asked questions; check your refund

status; check your estimated tax account; download forms, publications; get tax updates and other information.

Fax-on-demand forms: Forms are

available 24 hours a day,
7 days a week.	1 800 748-3676

Telephone assistance is available from 8:00 A.M. to 5:00 P.M. (eastern time), Monday through Friday.

To order forms and publications:	1 800	462-8100
Refund status:	1 800	443-3200
Personal Income Tax Information Center:	1 800	225-5829
From areas outside the U.S. and
outside Canada:	(518)	485-6800

Hearing and speech impaired (telecommunications device for the deaf (TDD) callers only): 1 800 634-2110

Payment Voucher for Form IT-370 Filed Online

Automatic Extension of Time to File for Individuals

Confirmation number

Your name

Spouse’s name

Local taxes

Balance due	Payment amount
$	$		0 0

Your social security number

Spouse’s social security number

371496

IT-370-V