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EMPLOYEE BENEFITS DIVISION
NYS HEALTH INSURANCE TRANSACTION FORM
PS404 (9/16)
INSTRUCTIONS: READ AND COMPLETE BOTH SIDES/PAGES. PLEASE PRINT AND CHECK THE APPROPRIATE CHOICES.EMPLOYEE INFORMATION
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What is ps-404 916?
The ps-404 916 is a form used for reporting income tax information.
Who is required to file ps-404 916?
Individuals or entities with income tax obligations are required to file ps-404 916.
How to fill out ps-404 916?
PS-404 916 can be filled out by providing accurate income tax information as per the guidelines provided on the form.
What is the purpose of ps-404 916?
The purpose of ps-404 916 is to report income tax information to the relevant tax authorities.
What information must be reported on ps-404 916?
Information such as income, deductions, credits, and other relevant tax details must be reported on ps-404 916.
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