- Paper: Letter (8.5in x 11in)
Copies to print: 2
- This form does not need to be sent to the New York State Tax Department.
- Employers and employees must keep a copy for their records.
- Employees must file a new form each year to continue to claim exemption.
- If the employer is a business approved to participate in the START-UP NY program that operates in a tax-free NY area, employees may be eligible to exclude from adjusted gross income wages earned from the employer.
- To be eligible for the exemption, the employee must meet the following conditions:
- employed by an approved business certified to participate in the START-UP NY program.
- perform work exclusively at the approved business's location within tax-free NY area during the tax year.
- be employed in a net new job created by the approved business in the tax-free NY area
- work at least 6 months of the tax year at the approved business's location