Form It-150 - Resident Income Tax Return Form - New York State Department Of Taxation And Finance - New York

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New York State Department of Taxation and Finance
IT-150
Resident Income Tax Return
(short form)
New York State • New York City • Yonkers
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 return, enter spouse’s name on line below)
Spouse’s first name and middle initial
 Spouse’s social security number
Spouse’s last name
Mailing address
(see instructions, page 13) (number and street or rural route)
Apartment number
New York State county of residence
City, village, or post office
State
ZIP code
School district name
Permanent home address
Apartment number
(see instructions, page 13) (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
Single
(A) Filing
(C)
Were you a New York City resident
status —
for all of 2005?
(Part-year residents
Married filing joint return
mark an
) ................ Yes
No
must file Form IT-201; see page 14.
(enter spouse’s social security number above)
X in
(D)
Can you be claimed as a dependent
Married filing separate return
one box:
on another taxpayer’s federal return?
(enter spouse’s social security number above)
............................................... Yes
No
(see page 14)
Head of household
(with qualifying person)
Staple check
or money order
here
(E)
Enter your 2-digit special condition code
Qualifying widow(er) with dependent child
number if applicable
.............................
(see page 14)
(B)
If you do not need a NYS income tax forms packet
If applicable, also enter your second 2-digit
mailed to you next year, mark an X in the box (
see page 14) ..........
special condition code number
..........................................
For help completing your return, see the combined instructions, Form IT-150/201-
I
, or the IT-RP-1 resident packet instructions.
Dollars
Cents
1 Wages, salaries, tips, etc......................................................................................................................
1.
2 Taxable interest income .......................................................................................................................
2.
3 Ordinary dividends ...............................................................................................................................
3.
4 Capital gain distributions ......................................................................................................................
4.
5 Taxable amount of IRA distributions. If received as a beneficiary, mark an X in the box..............
5.
6 Taxable amount of pensions and annuities. If received as a beneficiary, mark an X in the box ...
6.
7 Unemployment compensation..............................................................................................................
7.
8 Taxable amount of social security benefits
.................................................
8.
(also enter on line 17 below)
9 Add lines 1 through 8 ...........................................................................................................................
9.
10 Total federal adjustments to income
10.
(see page 15)
Identify:
11 Subtract line 10 from line 9. This is your federal adjusted gross income ........................................ 11.
12 Interest income on state and local bonds and obligations
.. 12.
(but not those of NYS or its local governments)
13 Public employee 414(h) retirement contributions from your wage and tax statements
... 13.
(see page 16)
14 Other
14.
(see page 16)
Identify:
15 Add lines 11 through 14 ....................................................................................................................... 15.
16 Pensions of NYS and local governments and federal government
16.
(see page 17)
17 Taxable amount of social security benefits
............... 17.
(from line 8 above)
18 Pension and annuity income exclusion
............................ 18.
(see page 18)
19 Other
19.
(see page 19)
Identify:
20 Add lines 16 through 19 ....................................................................................................................... 20.
21 Subtract line 20 from line 15. This is your New York adjusted gross income ................................... 21.
0 0 0 0
22 New York standard deduction
22.
.........................................
(see page 22)
0 0 0 0 0
23 Dependent exemptions
23.
(not the same as total federal exemptions; see page 22)
0 0 0 0
24 Add lines 22 and 23 ............................................................................................................................. 24.
25 Subtract line 24 from line 21. This is your taxable income ................................................................. 25.
Please file this original scannable
1501050094
return with the Tax Department.

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