Instructions For Form It-215 - Claim For Earned Income Credit - New York State Department Of Taxation And Finance - 2004 Page 2

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Page 2 of 4 IT-215-I (2004)
If you marked the box Person with
to show a loss. Mark an X in the
Line 3 — File Form IT-215 with your
original 2004 New York State income tax
disability , and your qualifying person is
appropriate box on line 8 to indicate if the
return. If you have already filed your
24 years of age or older, you must
amount reported is a profit or a loss. Be
original return, you may file Form IT-215
attach a letter from a physician stating
sure to enter your employer identification
by itself. If you haven’t previously filed
that the person is disabled. When we
number (EIN) for your business. If you
your income tax return for this year, you
receive a letter from your qualifying
have income or loss from more than one
must file one with this claim.
person’s doctor stating that your
business, enter the EIN representing your
qualifying person is, by definition,
primary business activity. If your primary
permanently and totally disabled, we will
business activity doesn’t have an EIN,
Line 4 — If you claimed qualifying
keep that statement on file, and you will
enter your social security number.
children on your 2004 federal EIC, list the
not have to provide this information again.
Line 10 — This amount can be found on
same children (up to two) in the spaces
Line 6 — Complete Worksheet A below
the appropriate line of your federal
provided on line 4 of Form IT-215. If you
to determine the amount to enter on
return. However, if you owe the federal
claimed more than two qualifying children
line 6.
alternative minimum tax, enter the
on your 2004 federal EIC, enter the
amount of the federal earned income
required information for two qualifying
Worksheet A
credit, as originally computed in the EIC
Wages, salaries, tips, etc.
children in the spaces provided on the
Worksheet in your federal instructions
1. Enter the amount from federal
form and attach a statement to your
Form 1040EZ, line 1;
before any reduction for the alternative
return with the required identifying
Form 1040A, line 7; or
minimum tax.
information for each additional child. Be
Form 1040, line 7;
sure to include your name and social
Line 11 — For 2004, the New York State
OR
security number on your attachment.
earned income credit is 30% (.30) of the
if you are a member of
the clergy or a church
federal earned income credit reduced by
Caution: To be eligible to claim the
employee who checked
any household credit allowed. The rate
New York State and city of New York
the Yes box in step 5,
has already been filled in for you.
earned income credits, you must provide
line 1, of the federal
a correct and valid social security number
Form 1040 instructions
Line 12 — This amount represents your
for lines 65a and 65b,
(SSN) for each child listed on line 4.
New York State earned income credit
enter the amount from
before it has been reduced by the
If you have applied for a social security
the first space of step 5,
line 2, of the
amount of household credit allowed.
number by filing federal Form SS-5 with
Form 1040
the Social Security Administration, but
If the amount on line 12 is more than 0,
instructions ........... 1.
you have not received it by April 15, 2005:
and you are a full-year city of New York
2. Enter the amount,
resident or a part-year city of New York
if any, from federal
Form 1040EZ, line 8b;
resident, be sure to complete
1) File Form IT-370 requesting an
Form 1040A line 41b; or
Worksheet C, City of New York earned
automatic extension of time to file until
Form 1040, line 65b .. 2.
income credit, on page 3 to compute
August 15, 2005. (This extension does
3. Add lines 1 and 2.
your CNY EIC. Enter the amount of your
not give you any extra time to pay any
Enter here and on
CNY EIC on Form IT-215, line 27.
tax owed. You should pay any
Form IT-215,
line 6. .................. 3.
New York taxes you expect to owe to
Form IT-100 filers, stop; the Tax
avoid interest or penalty charges. For
Department will compute your
Line 7 — If you received a taxable
more information, see Form IT-370,
New York State earned income credit
scholarship or fellowship grant that was
Application for Automatic Extension of
for you.
not reported on a federal Form W-2, if you
Time to File for Individuals.) or
were paid an amount as an inmate in a
Lines 13, 14, and 15 — Form IT-200
penal institution for work, or if you
filers, continue with line 13. Form IT-201
2) File your return on time without
received an amount as a pension or
or IT-203 filers, complete Worksheet B on
claiming the earned income credits
annuity from a nonqualified deferred
the back of Form IT-215. Then continue
and do not attach Form IT-215. After
compensation plan or a nongovernmental
with line 13.
receiving the SSN, file Form IT-215
section 457 plan (this amount may be
Line 16 — If you are attaching this claim
and claim the credits.
shown on your wage and tax statement(s)
to your original 2004 New York State
federal Form W-2, box 11), enter the
Be sure to mark an X in the box under the
income tax return and you answered No
amount from your federal Form 1040A
heading Full-time student if your child
at line 3:
instructions for line 41a, or from your
was born before 1986 and was a full-time
For filing status ➀, ➁, ➃, or ➄
federal Form 1040 instructions for
student under 24. Mark an X in this box
line 65a, the amount in the second space
Residents - Transfer the line 16
only if you marked the Yes box on your
(the subtract line) of step 5, line 2.
amount to Form IT-200, line 31, or
2004 federal Schedule EIC, line 4a.
Form IT-201, line 60.
Line 8 — Business income or loss
Be sure to mark an X in the box under the
Nonresidents - Transfer the line 16
applies only to federal Form 1040 filers.
heading Person with disability if your child
amount to Form IT-203, line 41.
Enter the amount of business income or
was born before 1986 and was
loss from your federal Form 1040
permanently disabled during any part of
Part-year residents - Transfer the
instructions, Earned Income Credit
2004. Mark an X in this box only if you
line 16 amount to Form IT-203,
Worksheet B, the total of lines 1e, 2c and
marked the Yes box on your 2004 federal
line 41, and continue on line 18.
3. Do not use a minus sign or brackets
Schedule EIC, line 4b.
(continued)

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