Resident Income Tax Return
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4IT-201
New York State Department of Taxation and Finance
Resident Income Tax Return
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New York State
New York City
Yonkers
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For the full year January 1, 2013, through December 31, 2013, or fiscal year beginning ...
and ending ...
For help completing your return, see the instructions, Form IT-201-I.
Your first name and middle initial
Your last name
Your social security number
(for a joint return, enter spouse’s name on line below)
Your date of birth (mm-dd-yyyy)
Spouse’s first name and middle initial Spouse’s last name
Spouse’s social security number
Spouse’s date of birth (mm-dd-yyyy)
New York State county of residence
Mailing address
Apartment number
(see instructions, page 12) (number and street or rural route)
City, village, or post office
State
ZIP code
Country
School district name
(if not United States)
Taxpayer’s permanent home address
Apartment number
(see instructions, page 12) (number and street or rural route)
School district
code number ...............
City, village, or post office
State
ZIP code
Taxpayer’s date of death Spouse’s date of death
Decedent
NY
information
D
Did you have a financial account
A Filing
Single
located in a foreign country?
............ Yes
No
(see page 13)
status
E
(1) Did you or your spouse maintain living
Married filing joint return
(mark an
quarters in NYC during 2013?
.. Yes
No
(enter spouse’s social security number above)
(see page 13)
X in one
box):
(2) Enter the number of days spent in NYC in 2013
Married filing separate return
...........
(any part of a day spent in NYC is considered a day)
(enter spouse’s social security number above)
F
NYC residents and NYC part-year
Head of household
(with qualifying person)
residents only
:
(see page 13)
(1) Number of months you lived in NYC in 2013 ...................
Qualifying widow(er) with dependent child
(2) Number of months your spouse
lived in NYC in 2013 ..........................................................
B
Did you itemize your deductions on
G
your 2013 federal income tax return? ............. Yes
No
Enter your 2-character special condition code
if applicable
......................................................
(see page 13)
C
Can you be claimed as a dependent
on another taxpayer’s federal return? ............. Yes
No
If applicable, also enter your second 2-character
special condition code ...........................................................
H Dependent exemption information
(see page 14)
First name and middle initial
Last name
Relationship
Social security number
Date of birth
(mm-dd-yyyy)
If more than 9 dependents, mark an X in the box.
201001130094
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