Office of Processing and Taxpayer Services
                 W A Harriman Campus
                 Albany NY 12227

                                     Seasonal Exception Worksheet for Form CT-222

Taxpayer’s name:                                                                Employer identification number (EIN):

Contact name:                                                  Contact title:                     Telephone number:                           (    )

Tax period ended: /    /

Mark an  Xin the applicable box(es)  State: MTA surcharge:

          A                     B                          C                  D   E                                                         F                     G
     Month of     Monthly allocated         Monthly allocated  Monthly allocated  Monthly allocated                                         Monthly tax           Monthly other
     tax year               amount for the  amount for the tax amount for the tax amount for the tax                                        credits for the       taxes for the
     (mm/yy)      tax year of penalty *     year one year prior to penalty* year one year prior to penalty* year one year prior to penalty* year of penalty       year of penalty
1 stmonth:
2 ndmonth:
3 rdmonth:
4 thmonth:
5 thmonth:
6 thmonth:
7 thmonth:
8 thmonth:
9 thmonth:
10 thmonth:
11 thmonth:
12 thmonth:
Of your 12-month liability period, provide the consecutive 6-month period in which you earned seventy percent or more of your income.
Start month:                                End month:

Signature of authorized person:                                                 Telephone number: (      )                                                  Date: /    /

TR-620.1 (7/11)

                                                                 Instructions

Line instructions
Column A — Enter the applicable month and year that corresponds with this line.
Column B — Enter the applicable monthly amount that corresponds to the highest tax base (before credits)* for the tax year of penalty.
Column C — Enter the applicable monthly amount that corresponds to the highest tax base (before credits)* for the tax year one year prior to penalty.
Column D — Enter the applicable monthly amount that corresponds to the highest tax base (before credits)* for the tax year two years prior to penalty.
Column E — Enter the applicable monthly amount that corresponds to the highest tax base (before credits)* for the tax year three years prior to penalty.
Column F — Enter the applicable monthly credit amount that corresponds with the tax credits applicable for that month.
Column G — Enter any other tax amounts that apply for that month.

* Highest tax base (before credits):
  • Entire net income (ENI)
  • Minimum taxable income (MTI)
  • Alternative ENI
  • Tax on premiums
  • Alternative tax
  • Gross earnings or gross income
  • Fixed dollar minimum tax (Article 9-A)

Fax your worksheet
Fax your completed worksheet to the Business Liability Resolution Center at (518) 435-8615. 

Need help?
If you have any questions or need further assistance, contact the Business Liability Resolution Center at (518) 485-0384.

TR-620.1 (7/11) (back)