The New York Form Ifb 1 is a document that business owners in the state of New York use to report their income and taxes. The form covers a variety of tax information, including corporate and personal income, as well as sales and payroll taxes. By submitting this form, business owners can ensure that they are meeting all applicable tax requirements in New York. The deadline for filing the New York Form Ifb 1 is generally at the end of April each year.
This page holds information about new york form ifb 1. It's definitely worth making the effort to read through this just before you start filling out your form.
| Question | Answer |
|---|---|
| Form Name | New York Form Ifb 1 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names |
NEW YORK STATE
DEPARTMENT OF FINANCIAL SERVICES INSURANCE FRAUDS BUREAU
25 BEAVER STREET
NEW YORK, NY 10004
DATE:
1). Information furnished by:__________________________
Address: _______________________________________
_______________________________________
NAIC # _______________________________________
Previously submitted? Yes ____ Log # ___________ No_____
PLEASE PRINT/TYPE INFORMATION
2)Brief statement of suspect transaction. Date of loss ___________ Amount of loss ____________ County_____
Type of loss: Auto___
If Auto or
STATEMENT
3)Identify parties to suspect transaction: Name(s) Address(es)
Additional information on suspect(s)
If Auto or Fraudulent cards give VIN # _________________________ Plate or License # ____________________
4) Identify your policy, claim or reference number under which the above transaction is recorded:
Claim # __________________________ Claim status_____________________________________________
Reference #_____________________________ Policy # _________________________ SIU #_______________
5)Name, title, address & telephone number of individual in your company who can provide detailed information:
NAME__________________________________________ TITLE _________________________________
ADDRESS __________________________________________________ TELEPHONE # _____________
6)Have you reported this transaction to any other law enforcement agency? Yes ____________ No____________
If yes, please furnish: Agency _________________________________________________________________
Address ___________________________________________________________________________________
Person contacted _________________________ Telephone #____________________Date of report _________
Continue on reverse or attach additional sheets as necessary.
Signed: _______________________________
Title: ________________________________
http://www.dfs.ny.gov