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NY IT-2104-IND exemption certificate

NY IT-2104-IND exemption certificatex


NY IT-2104-IND exemption certificate x



  • Paper: Letter (8.5in x 11in)
  • Copies to print: 2
    • This form does not need to be submitted to the New York State Tax Department.
    • Employers must keep a copy for their records.


  • To qualify for the exemption, the employee must be:
    • An enrolled member of a tribe or nation recognized by the United States or by New York State.
    • And a Native American who works and lives on that tribe's reservation.
  • The employee must notify the employer within 10 days of any change in status.
  • A penalty of $500 may be imposed for providing false information that decreases your withholding amount.
  • To be used by Native Americans to file exemption from state withholding tax.
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