Form It-214 - Claim For Real Property Tax Credit For Homeowners And Renters - New York Page 2

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IT-214 (1999) (back)

Schedule A - To be completed by homeowners. Enter the amounts you and all

qualified members of your household paid during 1999.

Real property taxes

(including school district taxes) ..........................................................................................................................

Special assessments .....................................................................................................................................................

The amount of taxes not paid due to the exemption for persons 65 or older under section 467 of the

Real Property Tax Law

This entry is optional

(veterans’ tax exemption does not qualify).

(see instructions) ............................

Real property taxes paid

Enter here and on line 10 .................................................................

(add lines 18 through 20).

Schedule B - To be completed by renters. Enter the amount of rent constituting real property taxes paid during 1999.

If your residence was 100% exempt from real property taxes, stop; you do not qualify for this credit.

Enter the total rent you and all members of your household paid during 1999 ............................................................

If line 22 includes charges for:

Enter:

heat, gas, electricity, furnishings and board ............................................

50% of line 22

heat, gas, electricity and furnishings .......................................................

25% of line 22

heat, gas and electricity ...........................................................................

20% of line 22

heat or heat and gas ...............................................................................

15% of line 22

none of the above ....................................................................................

Adjusted rent

(Subtract line 23 from line 22. If monthly average is over $450, stop; you do not qualify for this credit.) .......................

Enter 25% of line 24 here and on line 10.

(If over $1,350, stop; you do not qualify for this credit.) ..............................................

Schedule C - To be completed by homeowners and renters. Enter the household gross income of all household members.

List below the name, social security number, and the year of birth of everyone, including yourself, who lived in your

household in 1999.

Enter the total number of household members in the boxes ..

(Attach additional sheets if necessary.)

Social security number

Year of birth

Your name

1 9

Spouse’s name (if married)

1 9

Household member’s name

1 9

Household member’s name

1 9

Household member’s name

1 9

Enter the total of all amounts, even if not taxable, that you, your spouse (if married), and the above household members received during 1999.

Federal adjusted gross income

(from Form 1040A, line 18; Form 1040EZ, line 4; or Form 1040, line 33)

If you do not have to file a federal return, see Household gross income

on the front page of the instructions for this form .............................................................................

New York State additions to federal adjusted gross income .................................................................

Social security payments not included on line 27 .................................................................................

Supplemental security income payments (SSI) ....................................................................................

Pensions and annuities not included on lines 27 through 30 ...............................................................

Cash public assistance and relief ..........................................................................................................

Other income .........................................................................................................................................

Household gross income

Enter this amount here, and on line 11,

(add lines 27 through 33).

rounded to the nearest whole dollar ..........................................................................................................................

Direct deposit: If you are not attaching this claim to your income tax return, and want your credit (from line 17)

sent directly to your bank account, complete a, b, and c below

(see instructions).

a Routing number

b Type:

Checking

Savings

c Account number

142994

This is a scannable form; please file this original with the Tax Department.

IT-214 1999