New York State Department of Taxation and Finance
Resident Income Tax Return
New York State • New York City • Yonkers

IT-201

For the full year January 1, 2012, through December 31, 2012, or fiscal year beginning ... 12 and ending ...
For help completing your return, see the instructions, Form IT-201-I.

Your first name and middle initial
Your last name (for a joint return, enter spouse’s name on line below)
Your date of birth (mm-dd-yyyy)
Your social security number
Spouse’s first name and middle initial
Spouse’s last name
Spouse’s date of birth (mm-dd-yyyy)
Spouse’s social security number
Mailing address (see instructions, page 12) (number and street or rural route)
Apartment number
New York State county of residence
City, village, or post office
State ZIP code
Country (if not United States)
School district name
Permanent home address (see instructions, page 12) (number and street or rural route)
Apartment number
School district code number
City, village, or post office
State NY
ZIP code
Decedent information
Taxpayer’s date of death
Spouse’s date of death

A Filing status (mark an X in one box):
Single
Married filing joint return (enter spouse’s social security number above)
Married filing separate return (enter spouse’s social security number above)
Head of household (with qualifying person)
Qualifying widow(er) with dependent child

B Did you itemize your deductions on your 2012 federal income tax return?

C Can you be claimed as a dependent on another taxpayer’s federal return?

D Did you have a financial account located in a foreign country? (see page 13)

E (1) Did you or your spouse maintain living quarters in NYC during 2012? (see page 13)
(2) Enter the number of days spent in NYC in 2012 (any part of a day spent in NYC is considered a day)

F NYC residents and NYC part-year residents only (see page 13):
(1) Number of months you lived in NYC in 2012.
(2) Number of months your spouse lived in NYC in 2012

G Enter your 2-character special condition code if applicable (see page 13)
If applicable, also enter your second 2-character special condition code

H Dependent exemption information (see page 14)
If more than 9 dependents, mark an X in the box.
First name and middle initial
Last name
Relationship
Social security number
Date of birth (mm-dd-yyyy)

Federal income and adjustments (see page 14)
Whole dollars only

1 Wages, salaries, tips, etc.

2 Taxable interest income

3 Ordinary dividends

4 Taxable refunds, credits, or offsets of state and local income taxes (also enter on line 25)

5 Alimony received

6 Business income or loss (submit a copy of federal Schedule C or C-EZ, Form 1040)

7 Capital gain or loss (if required, submit a copy of federal Schedule D, Form 1040)

8 Other gains or losses (submit a copy of federal Form 4797)

9 Taxable amount of IRA distributions. If received as a beneficiary, mark an X in the box

10 Taxable amount of pensions and annuities. If received as a beneficiary, mark an X in the box

11 Rental real estate, royalties, partnerships, S corporations, trusts, etc. (submit copy of federal Schedule E, Form 1040)

12 Rental real estate included in line 11

13 Farm income or loss (submit a copy of federal Schedule F, Form 1040)

14 Unemployment compensation

15 Taxable amount of social security benefits (also enter on line 27)

16 Other income (see page 14)
Identify:

17 Add lines 1 through 11 and 13 through 16

18 Total federal adjustments to income (see page 14)
Identify:

19 Federal adjusted gross income (subtract line 18 from line 17)

New York additions (see page 14)

20 Interest income on state and local bonds and obligations (but not those of NYS or its local governments)

21 Public employee 414(h) retirement contributions from your wage and tax statements (see page 15)

22 New York’s 529 college savings program distributions (see page 15)

23 Other (see page 16)
Identify:

24 Add lines 19 through 23

New York subtractions (see page 19)

25 Taxable refunds, credits, or offsets of state and local income taxes (from line 4)

26 Pensions of NYS and local governments and the federal government (see page 19)

27 Taxable amount of social security benefits (from line 15)

28 Interest income on U.S. government bonds

29 Pension and annuity income exclusion (see page 19)

30 New York’s 529 college savings program deduction/earnings

31 Other (see page 20)
Identify:

32 Add lines 25 through 31

33 New York adjusted gross income (subtract line 32 from line 24)

Standard deduction or itemized deduction (see page 24)

34 Enter your standard deduction (table on page 24) or your itemized deduction (from Form IT-201-D)
Mark an X in the appropriate box:
Standard - or - Itemized

35 Subtract line 34 from line 33 (if line 34 is more than line 33, leave blank)

36 Dependent exemptions (not the same as total federal exemptions; see page 24)

37 Taxable income (subtract line 36 from line 35)

Tax computation, credits, and other taxes (see page 25)

38 Taxable income (from line 37 on page 2)

39 NYS tax on line 38 amount (see page 25 and Tax computation on pages 57, 58, and 59)

40 NYS household credit (page 25, table 1, 2, or 3)

41 Resident credit (see page 26)

42 Other NYS nonrefundable credits (Form IT-201-ATT, line 7)

43 Add lines 40, 41, and 42

44 Subtract line 43 from line 39 (if line 43 is more than line 39, leave blank)

45 Net other NYS taxes (Form IT-201-ATT, line 30)

46 Total New York State taxes (add lines 44 and 45)

New York City and Yonkers taxes, credits, and tax surcharges
See instructions on pages 26, 27, and 28 to compute New York City and Yonkers taxes, credits, and tax surcharges.

47 NYC resident tax on line 38 amount (see page 26)

48 NYC household credit (page 26, table 4, 5, or 6)

49 Subtract line 48 from line 47 (if line 48 is more than line 47, leave blank)

50 Part-year NYC resident tax (Form IT-360.1)

51 Other NYC taxes (Form IT-201-ATT, line 34)

52 Add lines 49, 50, and 51

53 NYC nonrefundable credits (Form IT-201-ATT, line 10)

54 Subtract line 53 from line 52 (if line 53 is more than line 52, leave blank)

55 Yonkers resident income tax surcharge (see page 28)

56 Yonkers nonresident earnings tax (Form Y-203)

57 Part-year Yonkers resident income tax surcharge (Form IT-360.1)

58 Total New York City and Yonkers taxes / surcharges (add lines 54 through 57)

59 Sales or use tax (see page 29; do not leave line 59 blank)

Voluntary contributions (see page 30)

60a Return a Gift to Wildlife
60b Missing/Exploited Children Fund
60c Breast Cancer Research Fund
60d Alzheimer’s Fund
60e Olympic Fund ($2 or $4; see page 30)
60f Prostate Cancer Research Fund
60g 9/11 Memorial
60h Volunteer Firefighting & EMS Recruitment Fund
60 Total voluntary contributions (add lines 60a through 60h)

61 Total New York State, New York City, and Yonkers taxes, sales or use tax, and voluntary contributions (add lines 46, 58, 59, and 60)

62 Enter amount from line 61

Payments and refundable credits (see page 31)
Submit your wage and tax statements with your return (see page 33).

63 Empire State child credit

64 NYS/NYC child and dependent care credit

65 NYS earned income credit (EIC)

66 NYS noncustodial parent EIC

67 Real property tax credit

68 College tuition credit

69 NYC school tax credit (also complete F on page 1; see page 31)

70 NYC earned income credit

71 Other refundable credits (Form IT-201-ATT, line 18)

72 Total New York State tax withheld

73 Total New York City tax withheld

74 Total Yonkers tax withheld

75 Total estimated tax payments and amount paid with Form IT-370

76 Total payments (add lines 63 through 75)

Your refund, amount you owe, and account information (see pages 33 through 36)

77 Amount overpaid (if line 76 is more than line 62, subtract line 62 from line 76)

78 Amount of line 77 to be refunded
Mark one refund choice: direct deposit (fill in line 83) - or - debit card - or - check
See pages 33 and 34 for information about your three refund choices.

79 Amount of line 77 that you want applied to your 2013 estimated tax (see instructions)

80 Amount you owe (if line 76 is less than line 62, subtract line 76 from line 62). To pay by electronic funds withdrawal, mark an X in the box and fill in lines 83 and 84.

See page 37 for the proper assembly of your return.

81 Estimated tax penalty (include this amount in line 80 or reduce the overpayment on line 77; see page 34)

82 Other penalties and interest (see page 35)

83 Account information for direct deposit or electronic funds withdrawal (see page 35). If the funds for your payment (or refund) would come from (or go to) an account outside the U.S., mark an X in this box (see pg. 35)
83a Account type: Personal checking - or - Personal savings - or - Business checking - or - Business savings
83b Routing number
83c Account number
84 Electronic funds withdrawal (see page 36)
Date
Amount

Third-party designee? (see instr.)
Print designee’s name
Designee’s phone number
E-mail:
Personal identification number (PIN)

Paid preparer must complete (see instr.)
Date
Preparer’s signature
Preparer’s NYTPRIN
Firm’s name (or yours, if self-employed)
Preparer’s PTIN or SSN
Address
Employer identification number
Mark an X if self-employed
E-mail:

Taxpayer(s) must sign here
Your signature
Your occupation
Spouse’s signature and occupation (if joint return)
Date
Daytime phone number
E-mail:

See instructions for where to mail your return.