Protest Document for Failure to File Penalties

New York State Department of Labor

PO Box 1939

Albany, NY 12201-1939

Failure to File Penalties may only be adjusted, abated or reviewed when all required parts of the, Quarterly Combined

Withholding, Wage Reporting and Unemployment Insurance Return (NYS- 45) have been filed. If you are submitting this

protest document, ensure all required parts of the NYS-45/NYS-45 ATT return are filed in order to avoid delays in the

review of your protest.

To protest the penalty assessment, complete this form (use blue or black ink) by placing an X in the appropriate

box(es)



and filling in all applicable blanks. Attach any supporting documents and sign below. Return the completed

form to the address above.

Employer Name:_______________________________ Taxpayer ID/FEIN: B –

 - 

____________________________________________

Address:_____________________________________

ER Number:

 -





__________________

__________________________

____________________________________________ Assessment ID: L –

 - 

Section I

 Form NYS-45 and/or NYS-45 ATT was filed (MM/DD/YY): ______/______/__________

Note: Attach a copy of the return(s) filed and if payment was made, proof of payment

 The return(s) was filed under a different Name, Taxpayer ID and ER No. from that shown on the billing notice.

The information appeared on the return as follows:

Name: ____________________________________________________________________________

Taxpay

er ID/FEIN: B -

 -



ER No.:

 -  - 



The business is seasonal. There were no wages paid for the period shown on the billing notice.

Section II

 The business ceased paying wages. Enter the last payroll date (MM/DD/YY): ______/______/__________

 The business has been sold or transferred. Date of sale or transfer (MM/DD/YY): ______/______/__________

Name and address of new owner: _____________________________________________________________

_____________________________________________________________

Note: If you ceased paying wages, sold or transferred your business during the period covered by the

Penalty Assessment, you are still required to file the Quarterly Combined Withholding, Wage

Reporting and Unemployment Insurance Return (NYS- 45) for the time you were active.

 I do not believe the business is required to file the return(s) because: _________________________________

________________________________________________________________________________________

 Other reason you believe this penalty should not be assessed: ______________________________________

________________________________________________________________________________________

Print Name:_________________________Signature:_________________________Date:______/______/__________

Title:________________________________ Daytime Phone: (_______) ________-______________ext __________

IA 198.P (12/20)