Form Nyc-1127 Draft - Return For Nonresident Employees Of The City Of New York Hired On Or After January 4, 1973 - 2017

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-1127
RETURN FoR NoNRESIDENT EMPloyEES oF ThE CITy oF NEw yoRk
2017
hIRED oN oR AFTER JANUARy 4, 1973
TM
Department of Finance
nn
Enter 2‑character special condition code if applicable. (See instructions):
PRINT OR TYPE
▼
First names and initials of employee and spouse:
Last name:
Name
n
n
AMENDED RETURN
Change
Home address (number and street):
Apt. no.:
TAXPAYER’S EMAIL ADDRESS
Address
n
Change
City and State:
Zip Code:
Country (if not US)
EMPLOYEE'S SOCIAL SECURITY NUMBER
NYC Department or
Employee
Spouse
Agency where employed:
▼
▼
SPOUSE’S SOCIAL SECURITY NUMBER
Daytime telephone number:
1 - FILING STATUS
MARRIED FILING JOINTLY
HEAD OF
SINGLE OR MARRIED
A.
Note:
B.
C.
If you file a joint Federal tax return but elect to
n
n
n
exclude a spouse’s income, see the special computation
OR SURVIVING SPOUSE
HOUSEHOLD
FILING SEPARATELY
Schedule A on the back of this form and use Filing Status C.
A. NUMBER OF MONTHS EMPLOYED IN 2017 ........................
EMPLOYEE: ___________________
SPOUSE: ___________________
B. DATE RETIRED FROM NYC SERVICE .................................
EMPLOYEE: ______-______-______
SPOUSE: ______-______-______
n
C.
CHECK BOX IF YOU AND YOUR SPOUSE ARE BOTH SUBJECT TO SECTION 1127.
Payment Amount
Payment
A.
Amount being paid electronically with this return
A
2 - 1127 LIABILITY CALCULATION
All the information you will need to complete this 1127 form comes directly from your NYS Income Tax Return. For your convenience, we
have listed where on your State tax return you can find this information depending on whether you filed a NYS Resident Income Tax Return
(NYS IT-201) or a NYS Non-Resident and Part-Year Resident Income Tax Return (NYS IT-203).
line
where do I get the amount?
Amount
1
NYS Taxable Income.
NYS IT-201, line 37
Note: If you file a joint Federal tax return
but elect to exclude a spouse’s income, see
◆
See instructions.
NYS IT-203, line 36
the special computation Schedule A on the
◆
back of this form and use Filing Status C.
2
Section 1127 liability plus Other New York
Page 2 liability rate schedules
◆
City Taxes, if any. See instructions.
NYS IT-201, line 51
◆
3
New York City School tax and other credits
See Page 2, Schedule B and Instructions
◆
4
New York City 1127 amount withheld
Form 1127.2
◆
5
Balance Due
If line 2 is greater than the sum of lines 3 and 4,
◆
enter balance due
6
Refund
If line 2 is less than the sum of lines 3 and 4, enter refund
◆
amount (not to exceed the amount on line 4). (See instr.)
3 - CERTIFICATION
I hereby certify that this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct and complete.
I authorize the Department of Finance to discuss this return with the preparer listed below. (see instructions)................................... YES
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SIgN
_________________________________________________________
__________________________
:
hERE
YOUR SIGNATURE
DATE
_________________________________________ _____________________ ________________ __________________________________
’
SIGNATURE OF PREPARER OTHER THAN TAXPAYER
EIN OR SSN OR PTIN
DATE
PREPARER
S EMAIL ADDRESS
_________________________________________________
_____________________________________________________________
’
PREPARER
S PRINTED NAME
ADDRESS
CITY
STATE
ZIP CODE
All RETURNS ExCEPT REFUND RETURNS
REMITTANCES
RETURNS ClAIMINg REFUNDS
ATTACh A CoMPlETE CoPy oF yoUR NEw yoRk STATE
PAy oNlINE wITh FoRM NyC-200V AT
INCoME TAx RETURN INClUDINg All SChEDUlES
NYC DEPARTMENT OF FINANCE
NyC.goV/ESERVICES
NYC DEPARTMENT OF FINANCE
oR
Payment must be made in U.S. dollars, drawn on a U.S. bank.
SECTION 1127
SECTION 1127
Mail Payment and Form NyC-200V oNly to:
P.O. BOX 5564
P.O. BOX 5563
NYC DEPARTMENT OF FINANCE
BINGHAMTON, NY 13902-5564
80011791
BINGHAMTON, NY 13902-5563
P.O. BOX 3933
NEW YORK, NY 10008-3933

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