Social Security Refund US Citizen

State employee requests a refund of prior year Social Security and Medicare tax certification.

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Social Security Refund US Citizen
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  1. Read through all pages of the document to find specific instructions if any
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  4. Get required signatures
  5. Scan a copy of the signed form for your records
  6. Send the original, completed, signed form to:         

Human Resources
120 Crofts Hall
North Campus

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Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: December 2014

Owner: State of New York Office of State Comptroller