New York State Department of Taxation and Finance
IT-201-X
Amended Resident Income Tax Return
•
•
New York State
New York City
Yonkers
1 4
For the full year January 1, 2014, through December 31, 2014, or fiscal year beginning ...
and ending ...
See the instructions, Form IT-201-X-I, for help completing your amended return.
Your first name
MI
Your last name
Your social security number
Your date of birth (mmddyyyy)
(for a joint return, enter spouse’s name on line below)
Spouse’s first name
MI
Spouse’s last name
Spouse’s social security number
Spouse’s date of birth (mmddyyyy)
Mailing address
Apartment number
New York State county of residence
(number and street or PO box)
City, village, or post office
State
ZIP code
Country
School district name
(if not United States)
Apartment number
Taxpayer’s permanent home address
(number and street or rural route)
School district
code number ...............
Taxpayer’s date of death
Spouse’s date of death
City, village, or post office
State
ZIP code
(mmddyyyy)
(mmddyyyy)
Decedent
NY
information
D2
Yonkers residents and Yonkers part-year residents only:
A Filing
Single
(1) Did you receive a property tax
status
freeze credit? ............................................... Yes
No
Married filing joint return
(mark an
(enter spouse’s social security number above)
(2) If Yes, enter
X in one
the amount ..............
00
box):
Married filing separate return
(enter spouse’s social security number above)
Did you receive a family tax relief credit? ........... Yes
No
D3
Head of household
(with qualifying person)
(1) Did you or your spouse maintain living
E
Qualifying widow(er) with dependent child
quarters in NYC during 2014? ..................... Yes
No
Did you itemize your deductions on
(2) Enter the number of days spent in NYC in 2014
B
your 2014 federal income tax return? ............ Yes
No
.........
(any part of a day spent in NYC is considered a day)
Can you be claimed as a dependent
NYC residents and NYC part-year residents only:
F
C
(1) Number of months you lived in NYC in 2014 ................
on another taxpayer’s federal return? ........... Yes
No
(2) Number of months your spouse
Did you file an amended federal return
D1
lived in NYC in 2014 ........................................................
............................................... Yes
No
(see instructions)
Enter your 2-character special condition code
G
if applicable
................................................
(see instructions)
If applicable, also enter your second 2-character
special condition code ..........................................................
H Dependent exemption information
First name
MI
Last name
Relationship
Social security number
Date of birth
(mmddyyyy)
If more than 7 dependents, mark an X in the box.
361001140094
For office use only