THE CITY OF NEW YORK-FINANCE ADMINISTRATION-DEPARTMENT OF TAX COLLECTION
EMPLOYER'S RETURN OF NEW YORK CITY PERSONAL INCOME AND EARNINGS TAX WITHHELD

•1973

FOR PERIOD	PRINT BUSINESS NAME AND ADDRESS BELOW		TAX WITHHELD (IF NONE EXPLAIN ON BACK)
FROM: 2/1/74	CITIZENS' COMMISSION ON SCIENCE, LAW & FOOD SUP		28 50
TO: 2/28/74	1230 YORK AVENUE	ZIP CODE 10021	INTEREST-PENALTY (SEE INSTRUCTIONS) 00 00
	NEW YORK, N.Y. 13 2752467	ENTER FEDERAL EMPLOYER IDENTIFICATION NUMBER	TOTAL AMOUNT DUE (PAYABLE TO CITY COLLECTOR) 28 50
READ EMPLOYER'S INSTRUCTIONS, AND ANSWER ALL QUESTIONS ON THIS FORM.
IS THIS YOUR FIRST REPORT OF TAX WITHHELD FROM EMPLOYEES?		YES	NO
IF "YES", ENTER DATE WHEN BUSINESS WAS STARTED.		19
IF "NO", ENTER DATE WHEN LAST RETURN WAS FILED.		February 15, 19 74
WRITE PREVIOUS NAME AND ADDRESS AND IDENTIFICATION NUMBER ON BACK OF CARD IF DIFFERENT FROM ABOVE		IF THIS IS A FINAL RETURN
INTEREST-PENALTY INSTRUCTIONS ADD 6% INTEREST PER YEAR FOR LATE PAYMENT AND ALSO A PENALTY OF 5% PER MONTH NOT TO EXCEED 25% FOR LATE FILING, THE PENALTY NEED NOT BE COMPUTED AND PAID NOW IF YOU CAN SHOW REASONABLE CAUSE FOR LATE FILING ON THE BACK OF THIS FORM.		WRITE THE WORDS "FINAL RETURN" ABOVE "TAX WITHHELD" BOX IN UPPER RIGHT. CHECK APPLICABLE BOX BELOW, GIVE EXPLANATION ON BACK OF CARD, AND FILE WITH FORMS NYC-2 AND NYC-3 WITHIN 30 DAYS. BUSINESS SOLD CEASED PAYING WAGES BUSINESS PERMANENTLY DISCONTINUED
THIS IS TO CERTIFY THAT, EXCEPT FOR CORRECTIONS REQUIRED FOR PRIOR PERIODS IN 1973, THE AGGREGATE AMOUNT OF TAX WITHHELD SHOWN ON THIS RETURN IS CORRECT FOR THE PERIOD REPORTED.		TELEPHONE NUMBER 360-1797
L. H. Lushbough		Exec. Secty.	3/11/74
SIGNATURE		TITLE	DATE

PRINTED IN U.S.A.

MAIL REMITTANCE TO: THE CITY OF NEW YORK, FINANCE ADMINISTRATION, DEPARTMENT OF TAX COLLECTION, BOX 3800, GENERAL POST OFFICE, NEW YORK, N.Y. 10001