Form Nyc-1127 - Form For Nonresident Employees Of The City Of New York Hired On Or After January 4, 1973 - 1999

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-
DO NOT WRITE IN THIS SPACE
FOR OFFICIAL USE ONLY
NEW YORK CITY DEPARTMENT OF FINANCE
N Y C
FORM FOR NONRESIDENT EMPLOYEES
OF THE CITY OF NEW YORK HIRED
1127
F I N A N C E
ON OR AFTER JANUARY 4, 1973
NEW YORK
1999
COMPUTATION OF PAYMENT DUE PURSUANT TO SECTION 1127 OF NEW YORK CITY CHARTER
PRINT OR TYPE
First names and initials of employee and spouse
Last name
EMPLOYEE'S SOCIAL SECURITY NUMBER
Home address (number and street)
Apt. no.
City and State
Zip Code
SPOUSE'S SOCIAL SECURITY NUMBER
Employee
Spouse
NYC Department or
Agency where employed
Daytime telephone number
EMPLOYEE
SPOUSE
Date current employment with the City of New York began:
.................................................................................................
A
Were you an employee of the City of New York for all of 1999?
........................................................................................
YES
NO
YES
NO
If "NO", enter period of 1999 employment by the City of New York:
.................................................................................
from: _____________ to: _____________
from: _____________ to: _____________
Were you a resident of New York City during any part of 1999?
........................................................................................
YES
NO
YES
NO
B
If "YES", enter period for which you were a New York City resident
.................................................................................
from: _____________ to: _____________
from: _____________ to: _____________
Did you earn any additional income in 1999 other than from the City of New York?
............................................
YES
NO
YES
NO
C
If "YES", state amount and include below in appropriate line (
W-2'
)
.........................................
ATTACH COPIES OF
S
$: ______________________
$ _________________________
Has the Internal Revenue Service or the New York State Income Tax Bureau corrected any taxable
D
income reported in a prior year?
:
(
) ________________________
Have amended Form(s) NYC-1127 been filed?
YES
STATE PERIOD
S
NO
YES
NO
Payment Enclosed
Pay amount shown on line 60 - Make check payable to: NYC Department of Finance
A.
Payment
FEDERAL INCOME AND ADJUSTMENTS
COLUMN A
COLUMN B
- Complete the federal amount column enter-
ing the items as they appear on your New York State Income Tax Return (Form IT-200, IT-201 or IT-203).
1127
FEDERAL AMOUNT
SECTION
EMPLOYEE
1. Wages, salaries, tips, etc. (attach copies of W-2's )
...............................................
1.
2. Taxable interest income
2.
...............................................................................................
3. Dividend income
............................................................................................................
3.
4. Taxable refunds of state and local income taxes
4.
(also enter on line 23 below) ....
5. Alimony received
...........................................................................................................
5.
6. Business income (or loss) (attach copy of federal Schedule C or C-EZ)
.........
6.
7. Capital gain (or loss
(attach copy of federal Schedule D)
7.
)
..................................
8. Other gains (or losses
(attach copy of federal Form 4797)
)
................................
8.
9. Taxable amounts of IRA distributions
9.
.......................................................................
10. Taxable amounts of pensions and annuities
........................................................... 10.
11. Rents, royalties, partnerships, estates, trusts, etc.
(attach copy of federal Sch. E) 11.
12. Farm income (or loss) (attach copy of federal Schedule F)
................................ 12.
13. Unemployment compensation (insurance)
............................................................... 13.
14. Taxable amount of social security benefits
(also enter on line 25 below) .............. 14.
15. Other income (attach list)
............................................................................................ 15.
16. Total (add lines 1 through 15)
.................................................................................... 16.
17. Total federal adjustments to income (attach list of items)
................................... 17.
18.
(line 16 less line 17)
FEDERAL ADJUSTED GROSS INCOME
.................................. 18.
NEW YORK ADJUSTED GROSS INCOME
NEW YORK ADDITIONS
19. Interest income on state and local bonds other than NYS and its localities
... 19.
20. Public employee 414(h) retirement contributions
.................................................. 20.
21. Other (attach list)
.......................................................................................................... 21.
22. Add lines 18 through 21
.............................................................................................. 22.
NEW YORK SUBTRACTIONS
23. Taxable refunds of New York State and local income taxes
(from line 4 above) . 23.
24. Pensions of NYS and local governments and the federal government ...........
24.
25. Taxable social security benefits
(from line 14 above) ............................................... 25.
26. Interest income on United States government bonds
........................................... 26.
27. Pension and annuity income exclusion
..................................................................... 27.
28. Other (attach list)
........................................................................................................... 28.
29. Total subtractions (add lines 23 through 28)
........................................................... 29.
30.
(line 22 less line 29) (transfer amount from ...........
TOTAL NEW YORK INCOME
column B to line 45
) ...................................................................................................... 30.
ATTACH A COMPLETE COPY OF YOUR NEW YORK STATE INCOME TAX RETURN INCLUDING ALL SCHEDULES.

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