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This is needed only if bills are not in your own name where you live To Whom It May Concern: Date State of New York SS. County of New York I, Name, who being duly sworn, depose and say: I reside at

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What is this is needed only?

This is needed only for specific purposes.

Who is required to file this is needed only?

Only individuals or organizations meeting certain criteria are required to file this.

How to fill out this is needed only?

To fill out this, you must provide accurate and complete information based on the requirements.

What is the purpose of this is needed only?

The purpose of this is to ensure compliance with rules and regulations.

What information must be reported on this is needed only?

Certain specific information must be reported on this.

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