Form It-644 - Workers With Disabilities Tax Credit

Form It-644 - Workers With Disabilities Tax Credit - 2015 Page 2

DRAFT

Page 2 of 3 IT-644 (2015)

Schedule A – Individual (including sole proprietor), partnership, and estate or trust

(see instructions) (cont’d)

Part 2 – Credit for qualified part-time employees

(see instructions)

Qualified employee’s

Qualified wages paid

Multiply column D

Enter lesser of

social security number

hire date

termination date

by 10% (.10)

column E

(see instructions)

(mmddyyyy)

or 2,500

3 Total of column F amounts from additional Form(s) IT-644, if any ..............................................

4 Add column F amounts

...................................................................

(include any amount on line 3)

5 Total credit

.......................................................................................................

(add lines 2 and 4)

Individuals and partnerships: Enter the line 5 amount on line 12.

Fiduciaries: Include the line 5 amount on line 8.

Schedule B – Partner’s, shareholder’s, or beneficiary’s share of credit

(see instructions)

If you were a partner in a partnership, a shareholder of a New York S corporation, or a beneficiary of an estate or trust and received a

share of the credit from that entity, complete the following information for each partnership, New York S corporation, or estate or trust.

For Type, enter P for partnership, S for S corporation, or ET for estate or trust.

Name of entity

Type

Employer identification number

Share of credit

6 Total of column D amounts from additional Form(s) IT-644, if any ..............................................

7 Add total column D amounts

...........................................................

(include any amount on line 6)

Fiduciaries: Include the line 7 amount on line 8.

All others: Enter the line 7 amount on line 13.

644002150099

Form It-644 - Workers With Disabilities Tax Credit - 2015 Page 2