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Click ‘Get Form’ to open it in the editor.
Begin by entering your Name, Social Security Number, and Address in Section 1. Ensure all details are accurate for processing.
In Section 2, specify the calendar year for which you are claiming a refund, along with the filing date, your signature, and telephone number.
Proceed to Section 3 where you will list each employer you worked for during the calendar year. Include their name, address, telephone number, and wages paid.
Attach a copy of Federal Form W-2 for each employer listed. Remember that photocopies will not be accepted; ensure they are legible.
Review your completed form carefully before signing it. Once satisfied, return it to the Division of Taxation at the specified address.
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