Administration:

1/5/11 through 12/21/11

Institution:

1/13/11 through 12/29/11

Box 1

Income Code

The two digit code populated in this box identifies the type of income received. This code is populated on the employee 1042 Tax Balances page.

Box 2

Gross income

The amount is the gross sum of all payments made for calendar year 2011.

Box 3

Withholding allowances

This box contains the value of the withholding allowance(s) as claimed in the Federal Tax Data page.

Box 4

Net Income

This box is only populated if there is an amount in box 3.

Box 5

Tax Rate

This box is populated with the tax rate applied to the amount in box 2 or box 4.

Box 6

Exemption Code

The exemption code identifies the authority for the exemption or tax rate.  The only exemption codes that apply to the types of payments made by the State of New York are Exemption Code 04 (Exempt under tax treaty) and 00 (Not Applicable).

Box 7

Federal tax withheld

This box is populated with the value of tax withheld. This box will contain a value of “0” if no taxes were withheld.

Box 8

Withholding by other agents

The State of New York does not withhold for other agents. This box will be populated with the value “0”.

Box 9

Total withholding credit

The amount in this is box should always match the amount in box 7.

Box 10

Amount repaid to recipient

 Not applicable.

Box 11

Withholding agent’s EIN

This box is populated with the Employer Identification Number for the company the Form 1042-S is being issued under. 
 
CUNY 13-3893536  
NYS 14-60132000

Box 12a

Box 12b -12d

WITHHOLDING AGENT’S name

This box is populated with the name of the Company the Form 1042-S is being issued under.
 
City University of New York  (CUNY)
State of New York  (NYS)

WITHHOLDING AGENT’S Address

This box is populated with the address of the Company the Form 1042-S is being issued under.

Box 13a

RECIPIENT’S names

This box is populated with the name of the recipient.

Box 13b

Recipient code

This box is populated with the recipient code.   The recipient code that applies to the recipients of Form 1042-S issued by the State of New York is recipient code (01) Individual.

Box 13c-13e

RECIPIENT’S address

This box is populated with the address of the recipient from personal data.

Box 14

Recipient’s U.S. TIN, if any

This box is populated with the employee’s Social Security (SSN) number as written in the national id field on the Modify a Person page or the Taxpayer Identification Number (ITIN) as written on the Federal Tax Data page.  The SSN or ITIN box will also be checked.
If the employee has no SSN or ITIN this box will be blank. The SSN or ITIN box will also be blank.

Box 15

Recipient’s foreign tax identifying number, if any

Populating this box is optional and the information is not maintained in PayServ.

Box 16

County Code

This box contains the two character country code for the country the recipient claims residency. This value will differ from the value populated on the Federal Tax Data page due to the number of characters permitted.

Box 17-25

Various

Not applicable.