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EMPLOYEE BENEFITS DIVISION State of New York Department of Civil Service Albany, NY 12239 NYS HEALTH INSURANCE TRANSACTION FORM PS-404 (12/11) INSTRUCTIONS: READ AND COMPLETE BOTH SIDES/PAGES. PLEASE
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The NYS PS404 Instructions Form is a document that provides guidance on how to properly complete and file the PS404 form for New York State.
All individuals or entities that have qualifying income from New York sources are required to file the NYS PS404 Instructions Form.
To fill out the NYS PS404 Instructions Form, you need to carefully follow the instructions provided in the document. It will guide you through the various sections and provide the necessary information for accurate completion.
The purpose of the NYS PS404 Instructions Form is to provide taxpayers with the instructions and guidelines for correctly reporting their New York source income.
The NYS PS404 Instructions Form requires individuals or entities to report their income from New York sources, including details about the nature and amount of income earned.
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