Form Nyc-1127 - For Nonresident Employees Of The City Of New York Hired On Or After January 4, 1973 - 2006

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FORM FOR NONRESIDENT EMPLOYEES
N Y C
OF THE CITY OF NEW YORK HIRED
1127
ON OR AFTER JANUARY 4, 1973
FINANCE
NEW YORK
THE CITY OF NEW YORK
DEPARTMENT OF FINANCE
n y c . g o v / f i n a n c e
-
DO NOT WRITE IN THIS SPACE
FOR OFFICIAL USE ONLY
2006
AMENDED RETURN
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 2006?
........................................................................................
YES
NO
YES
NO
If "NO", enter period of 2006 employment by the City of New York:
from: _____________ to: _____________
from: _____________ to: _____________
.................................................................................
Did you retire from New York City service as of December 31, 2006?
............................................................................
YES
NO
YES
NO
B
If “YES”, enter date employment with the City of New York ended:
...................................................................................
Were you a resident of New York City during any part of 2006?
........................................................................................
YES
NO
YES
NO
C
If "YES", enter period for which you were a New York City resident
from: _____________ to: _____________
from: _____________ to: _____________
.................................................................................
Did you earn any additional income in 2006 other than from the City of New York?
............................................
YES
NO
YES
NO
D
$: ________________________________
$ _________________________________
If "YES", state amount and include below in appropriate line (
W-2'
)
.........................................
ATTACH COPIES OF
S
FILING STATUS
A.
B.
C.
MARRIED FILING JOINTLY OR SURVIVING SPOUSE
HEAD OF HOUSEHOLD
SINGLE OR MARRIED FILING SEPARATELY
Payment Enclosed
A.
Payment
Pay amount shown on line 43 - Make check payable to: NYC Department of Finance
COLUMN B
FEDERAL INCOME AND ADJUSTMENTS
- Complete the federal amount (column A) enter-
COLUMN A
1127
SECTION
EMPLOYEE
ing the items as they appear on your New York State Income Tax Return (Form IT-200, IT-201 or IT-203).
FEDERAL AMOUNT
(
)
SEE INSTRUCTIONS
1. Wages, salaries, tips, etc. (attach copies of W-2's)
. ............................................
1a. _______________________________
1b. _______________________________
2. Taxable interest income
.............................................................................................
2a. _______________________________
2b. _______________________________
3. Dividend income
..........................................................................................................
3a. _______________________________
3b. _______________________________
4. Taxable refunds of state and local income taxes
(also enter on line 24) .............
4a. _______________________________
4b. _______________________________
5. Alimony received
..........................................................................................................
5a. _______________________________
5b. _______________________________
6. Business income (or loss) (attach copy of federal Schedule C or C-EZ)
........
6a. _______________________________
6b. _______________________________
7. Capital gain (or loss
(attach copy of federal Schedule D)
)
.................................
7a. _______________________________
7b. _______________________________
8. Other gains (or losses
(attach copy of federal Form 4797)
)
..............................
8a. _______________________________
8b. _______________________________
9. Taxable amounts of IRA distributions
......................................................................
9a. _______________________________
9b. _______________________________
10. Taxable amounts of pensions and annuities
..........................................................
10a. _______________________________
10b. ______________________________
11. Rents, royalties, partnerships, estates, trusts, etc.
(attach copy of federal Sch. E) .....
11a. _______________________________
11b. ______________________________
12. Farm income (or loss) (attach copy of federal Schedule F)
..............................
12a. _______________________________
12b. ______________________________
13. Unemployment compensation (insurance)
.............................................................
13a. _______________________________
13b. ______________________________
14. Taxable amount of social security benefits
(also enter on line 26) .......................
14a. _______________________________
14b. ______________________________
15. Other income (attach list)
..........................................................................................
15a. _______________________________
15b. ______________________________
16. Total (add lines 1 through 15)
..................................................................................
16a. _______________________________
16b. ______________________________
17. Total federal adjustments to income (attach list of items)
..................................
17a. _______________________________
17b. ______________________________
18.
(line 16 less line 17)
.................................
FEDERAL ADJUSTED GROSS INCOME
18a. _______________________________
18b. ______________________________
ATTACH A COMPLETE COPY OF YOUR NEW YORK STATE INCOME TAX RETURN INCLUDING ALL SCHEDULES
80010690
NYC-1127 2006

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