Form Nyc-210 - Claim For New York City School Tax Credit Form - New York State Department Of Taxation And Finance

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NYC-210
New York State Department of Taxation and Finance
Claim for New York City School Tax Credit
Important: You must enter your social security number(s) in the boxes to the right.
 Your social security number
Your first name and middle initial
Your last name
(for a joint claim, enter spouse’s name on line below)
Spouse’s first name and middle initial
 Spouse’s social security number
Spouse’s last name
NYS county of residence while living in NY City
Mailing address
Apartment number
(number and street or rural route)
City, village, or post office
State
ZIP code
Address of New York City residence that qualifies you for this credit, if different from above
City
State
ZIP code
Taxpayer’s date of death Spouse’s date of death
Decedent
NY
information:
Use this form only if you are not required to file a 2005 Form IT-150, IT-201, or IT-203, and you lived in New York City
for any part of 2005. You lived in New York City if you lived in any of the following counties during 2005: Kings County (Brooklyn),
Bronx, New York County (Manhattan), Richmond County (Staten Island), and Queens. If you did not live in any of these counties
for all or part of the year, stop; you do not qualify for this credit.
Married but filing a separate claim
Type of claim —
c
a
Single
(complete Part 1 only)
(complete Part 1 only)
mark an X in one box
Married filing a combined claim
b
(see instructions)
d
Surviving spouse
(complete Part 1 only)
(complete Part 1 and Part 2)
1
Part
1 Can you be claimed as a dependent on another taxpayer’s 2005 federal return? ...........................
1.
Yes
No
If you marked an X in box a, c, or d above, and marked the Yes box at line 1, stop;
you do not qualify for the credit. All other filers continue with line 2.
2 Enter the number of months during 2005 that you lived in New York City ........................................
2.
months
If you marked an X in box b above, continue with line 3. All other filers continue with line 5.
2
Part
Continue with line 3 only if you marked an X in box b above.
3 Can your spouse be claimed as a dependent on another taxpayer’s 2005 federal return? ............
3.
Yes
No
If you marked an X in the Yes box at both lines 1 and 3, stop; you do not qualify for this
credit. All other filers continue with line 4.
4 Enter the number of months during 2005 your spouse lived in New York City
4.
......
months
(see instructions)
Direct deposit
5
If you choose to have your refund sent directly to your bank account, complete the following
:
(see instructions)
a Routing number
b Account type:
Checking
Savings
c Account number
Yes
No
Do you want to allow another person to discuss this claim with the Tax Dept?
(see instr.)
(complete the following)
Third–
party
Designee’s name
Designee’s phone number
Personal identification
designee
number (PIN)
(
)
 Paid preparer’s use only 
 Taxpayer(s) sign here 
Preparer’s signature
SSN or PTIN:
Your signature
Firm’s name (or yours, if self-employed)
Employer identification number
Your occupation
Address
Mark an X if
Spouse’s signature and occupation (if joint claim)
self-employed
Date
Date
Daytime phone number (optional)
(
)
File your claim as soon as you can after January 1, 2006. You must file your 2005 claim
no later than April 15, 2009. Mail your claim to:
STATE PROCESSING CENTER, PO BOX 61000, ALBANY NY 12261-0001.
Please file this original scannable
2101050094
credit form with the Tax Department.

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