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MT-170 (8/11) (back)
If an outside individual or firm prepared the return, all applicable entries You may not be liable for penalties if your failure to file or remit the fees is
in the paid preparer section must be completed, including identification due to reasonable cause and not due to willful neglect. If you think you are
numbers (see Paid preparer identification numbers). Failure to sign the not liable for these additional charges, attach a statement to your return
return will delay the processing of any refunds and may result in penalties. explaining the delay in filing, payment, or both (Tax Law section 1085).
Paid preparer identification numbers —New York State Tax Law requires Note: You may compute your penalty and interest by accessing our Web
certain paid tax return preparers and facilitators of refund anticipation loans site, or you may call and we will compute the penalty and interest for you
(RALs) and refund anticipation checks (RACs) to register electronically with (see Need help? ).
the Tax Department. When completing this section, you must enter your
New York tax preparer registration identification number (NYTPRIN) if you • If you understate the net amount of fees due — If the net amount of
are required to have one. (Information on the New York State Tax Preparer fees you report is understated by 10% or $5,000, whichever is greater,
Registration Program is available on our Web site (see Need help? ).) In you must pay a penalty of 10% of the amount of understated fees.
addition, you must enter your federal preparer tax identification number You may not be liable for this penalty if (1) there is or was substantial
(PTIN) if you have one; if not, you must enter your social security number authority for your calculation of the net amount, (2) there is adequate
(SSN). (PTIN information is available at www.irs.gov.) disclosure on the return or in an attached statement, or (3) there was
reasonable cause for the understatement (see Tax Law section 1085(k)).
Attach check or money order payable to: Commissioner of Taxation and
Finance
On your check, write Form MT‑170, your sales tax identification number, and the Need help?
period for which you are reporting.
Visit our Web site at www.tax.ny.gov
Fee for payments returned by banks • get information and manage your taxes online
The law allows the Tax Department to charge a $50 fee when a check, • check for new online services and features
money order, or electronic payment is returned by a bank for nonpayment.
However, if an electronic payment is returned as a result of an error by Business Tax Information Center: (518) 457-5342
the bank or the department, the department won’t charge the fee. If your To order forms and publications: (518) 457-5431
payment is returned, we will send a separate bill for $50 for each return or
other tax document associated with the returned payment.
Text Telephone (TTY) Hotline
Penalties and interest (for persons with hearing and
Interest speech disabilities using a TTY): (518) 485-5082
• If you pay after the due date — If you do not pay the entire net amount
of fees due (line 3) on or before the due date, you must pay interest on Privacy notification
the amount of the underpayment from the due date of the return to the The Commissioner of Taxation and Finance may collect and maintain
date full payment is made. personal information pursuant to the New York State Tax Law, including but
Penalties not limited to, sections 5‑a, 171, 171‑a, 287, 308, 429, 475, 505, 697, 1096,
• If you file and pay after the due date — Compute additional charges 1142, and 1415 of that Law; and may require disclosure of social security
for late filing and late payment on the net amount of fees due, minus any numbers pursuant to 42 USC 405(c)(2)(C)(i).
payment made on or before the due date. This information will be used to determine and administer tax liabilities
A. If you do not file a return when due, add to the net fees 5% per and, when authorized by law, for certain tax offset and exchange of tax
month up to 25% (Tax Law section 1085(a)(1)(A)). information programs as well as for any other lawful purpose.
B. If you do not file a return within 60 days of the due date, the Information concerning quarterly wages paid to employees is provided
additional charge in item A above cannot be less than the smaller to certain state agencies for purposes of fraud prevention, support
of $100 or 100% of the net fees required to be shown on the return enforcement, evaluation of the effectiveness of certain employment and
(Tax Law section 1085 (a)(1)(B)). training programs and other purposes authorized by law.
C. If you do not pay the net fees shown on a return when due, Failure to provide the required information may subject you to civil or
add to the net fees ½% per month up to a total of 25% (Tax Law criminal penalties, or both, under the Tax Law.
section 1085 (a)(2)).
D. The total of the additional charges in items A and C may not This information is maintained by the Manager of Document Management,
exceed 5% for any one month, except as provided for in item B NYS Tax Department, W A Harriman Campus, Albany NY 12227;
above (Tax Law section 1085 (a)). telephone (518) 457‑5181.
MT-170 (8/11) (back)
I hereby certify that this return is true and correct. I make these statements with the knowledge that knowingly making a false or fraudulent
statement on this document is a misdemeanor under section 210.45 of the Penal Law.
Signature of authorized person Official title
Authorized
person E‑mail address of authorized person Telephone number Date
( )
Paid Firm’s name (or yours if self-employed) Firm’s EIN Preparer’s PTIN or SSN
preparer Signature of individual preparing this document Address City State ZIP code
use
only E‑mail address of individual preparing this document Preparer’s NYTPRIN Date
(see instr.)
Mail to: NYS TAX DEPARTMENT
WASTE TIRE MANAGEMENT FEE
PO BOX 4100
BINGHAMTON NY 13902-4100
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