Resident Income Tax Return Page 2

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Page 2 of 4 IT-201 (2016)
Your social security number
Federal income and adjustments (see page 15)
Whole dollars only
.
1 Wages, salaries, tips, etc. ...........................................................................................................
1
00
.
2 Taxable interest income ...............................................................................................................
2
00
.
3 Ordinary dividends ......................................................................................................................
3
00
.
4 Taxable refunds, credits, or offsets of state and local income taxes
...........
4
(also enter on line 25)
00
.
5 Alimony received .........................................................................................................................
5
00
.
6 Business income or loss
..........................
6
(submit a copy of federal Schedule C or C-EZ, Form 1040)
00
.
7 Capital gain or loss
..............................
7
(if required, submit a copy of federal Schedule D, Form 1040)
00
.
8 Other gains or losses
8
.............................................................
(submit a copy of federal Form 4797)
00
.
9 Taxable amount of IRA distributions. If received as a beneficiary, mark an X in the box ...
9
00
.
10 Taxable amount of pensions and annuities. If received as a beneficiary, mark an X in the box
10
00
.
11 Rental real estate, royalties, partnerships, S corporations, trusts, etc.
11
00
(submit copy of federal Schedule E, Form 1040)
.
12 Rental real estate included in line 11 ................................. 12
00
.
13 Farm income or loss
............................................. 13
(submit a copy of federal Schedule F, Form 1040)
00
.
14 Unemployment compensation ..................................................................................................... 14
00
15 Taxable amount of social security benefits
.................................................. 15
.
(also enter on line 27)
00
.
16 Other income
(see page 15) Identify:
16
00
17 Add lines 1 through 11 and 13 through 16 ................................................................................ 17
.
00
.
18 Total federal adjustments to income (
18
see page 15) Identify:
00
.
19 Federal adjusted gross income (
) ..................................................... 19
subtract line 18 from line 17
00
New York additions (see page 16)
.
20 Interest income on state and local bonds and obligations
20
(but not those of NYS or its local governments)
00
.
21 Public employee 414(h) retirement contributions from your wage and tax statements
21
(see page 16)
00
.
22 New York’s 529 college savings program distributions
.......................................... 22
(see page 16)
00
.
23 Other
............................................................................................................. 23
(Form IT-225, line 9)
00
.
24 Add lines 19 through 23 .............................................................................................................. 24
00
New York subtractions (see page 17)
.
25 Taxable refunds, credits, or offsets of state and local income taxes
25
(from line 4)
00
.
26 Pensions of NYS and local governments and the federal government
26
00
(see page 17)
.
27 Taxable amount of social security benefits
........ 27
(from line 15)
00
.
28 Interest income on U.S. government bonds ...................... 28
00
.
29 Pension and annuity income exclusion
........ 29
(see page 18)
00
.
30 New York’s 529 college savings program deduction/earnings 30
00
.
31 Other (
................................................... 31
Form IT-225, line 18)
00
.
32 Add lines 25 through 31 .............................................................................................................. 32
00
.
33 New York adjusted gross income
.................................................. 33
(subtract line 32 from line 24)
00
Standard deduction or itemized deduction (see page 20)
34 Enter your standard deduction
or your itemized deduction
(table on page 20)
(from Form IT-201-D)
.
Mark an X in the appropriate box:
Standard
Itemized 34
- or -
00
.
35 Subtract line 34 from line 33
.......................................... 35
(if line 34 is more than line 33, leave blank)
00
.
36 Dependent exemptions
..................... 36
000
00
(enter the number of dependents listed in item H; see page 20)
.
37 Taxable income
............................................................................... 37
(subtract line 36 from line 35)
00
201002160094

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