Third-party designee

Do you want to authorize a friend, family member, return preparer, or any other individual (third-party designee) to discuss this tax return and questions arising from it with the New York State Tax Department?

If No , mark an X in the No box.

If Yes , mark an X in the Yes box. Print the designee’s name, phone number, email address, and any five numbers the designee chooses as their personal identification number (PIN). If you want to authorize the paid preparer who signed your return to discuss it with the Tax Department, print the preparer’s name and phone number in the spaces for the designee’s name and phone number (you do not have to provide an email address or PIN).

If you mark the Yes box, you (and your spouse, if filing a joint return) are authorizing the Tax Department to discuss with the designee any questions related to this return. You are also authorizing the designee to give and receive confidential taxpayer information relating to:

this return, including missing information,

any notices or bills arising from this filing that you share with the designee (they will not be sent to the designee),

any payments and collection activity arising from this filing, and

the status of your return or refund.

This authorization will not expire but will only cover matters relating to this return. If you decide to revoke this designee’s authority at any time, call the Individual Contact Center for assistance.

You are not authorizing the designee to receive your refund, bind you to anything (including any additional tax liability), or otherwise represent you before the Tax Department. If you want someone to represent you or perform services for you beyond the scope of the third-party designee, you must designate the person using a power of attorney (for example, Form POA-1, Power of Attorney ). For additional information on third-party designees and other types of authorizations, see Power of attorney and other authorizations or visit our website at www.tax.ny.gov (search: POA-1 ).