Empire State Apprenticeship Tax Credit Program

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Empire State Apprenticeship Tax Credit Program - Employer Application

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Empire State Apprenticeship Tax Credit Program

Employer Application

* Indicates required fields

Questions? Need assistance? Call (877) 226-5724 or Email

Overview of Empire State Apprenticeship Tax Credit Program

To apply, you must be a sponsor of an active or probationary NYS Registered Apprenticeship (RA) program or a signatory of an active or probationary NYS RA group program. You must submit one Employer Application form for each trade.

I am a:

Sponsor

Signatory Employer

Name of NYS Registered Apprenticeship Sponsor:

Sponsor Code:

Name of NYS Registered Apprenticeship Trade:

ATP Code:

Name of Employer Applying for this Tax Credit:

Industry Sector:

Employer Physical Address:

Employer Physical Address Line 1:

Employer Physical Address Line 2:

City:

State:

Zip:

Employer Mailing Address:

Mailing Address Same as Physical Address

Employer Mailing Address Line 1:

Employer Mailing Address Line 2:

City:

State:

Zip:

Contact Information of Person Submitting the Form

Name:

Job Title:

Email:

Confirm E-mail:

Phone Number:

Extension:

Fax Number:

If you are a third party submitting this application on behalf of the employer, please provide the following contact information for a representative at the business.

Business Name:

Business Representative Name:

Email:

Confirm E-mail:

Phone Number:

Extension:

For efficiency purposes we will be communicating via email unless businesses request differently.

Terms of Service Agreement

An Empire State Apprenticeship Tax Credit Final Report will be submitted for each of the qualified apprentices being claimed.
I agree to allow The NYS Department of Tax and Finance to share my wage records with the NYS Department of Labor (NYSDOL). However, any information shared as a result of this agreement shall not be available for disclosure or inspection under the state freedom of information law.
I agree to allow NYSDOL and its agents access to any and all books and records they may require to monitor compliance.
I understand I must reapply for this tax credit each tax year.
I understand that submission of this form does not guarantee entitlement to the tax credit.
I understand that if awarded a preliminary certificate of tax credit that I will need to submit a final report to NYSDOL for tax credit determination.
To the best of my knowledge, this information is true, correct and complete. I am aware that there are significant civil and criminal penalties for filing false documents or other information with the government.

By checking this box and submitting this form, I agree to the above Terms of Service Agreement.

Department of Labor

Empire State Apprenticeship Tax Credit Program

Employer Application

Contact Information of Person Submitting the Form

Terms of Service Agreement