IT-2104.1 Nonresidence of New York State, City of New York or City of Yonkers Certificate

Employee certifies that they are not a resident of New York State, New York City or City of Yonkers for tax purposes.

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  6. Send the original, completed, signed form to:         

Human Resources
University at Buffalo
Townsend Hall
205 Hayes Road
Buffalo, NY 14214

Need Help Completing the Form?

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Robert Palmer


Research Foundation (RF) Human Resources

Phone: 716-645-4476


Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: September 2011

Owner:  New York State Department of Taxation