Form It-203-X - Amended Nonresident And Part-Year Resident - 2014

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IT-203-X
New York State Department of Taxation and Finance
Amended Nonresident and Part-Year Resident
New York State • New York City • Yonkers
Income Tax Return
14
For the year January 1, 2014, through December 31, 2014, or fiscal year beginning ...........
and ending ...........
See the instructions, Form IT-203-X-I, for help completing your amended return.
Your first name and middle initial
Your social security number
Your last name
(for a joint return, enter spouse’s name on line below)
Your date of birth (mm-dd-yyyy)
Spouse’s first name and middle initial Spouse’s last name
Spouse’s social security number
Spouse’s date of birth (mm-dd-yyyy)
New York State county of residence
Mailing address
(number and street or PO box)
Apartment number
City, village, or post office
State
ZIP code
Country
School district name
(if not United States)
Taxpayer’s permanent home address
Apartment no.
City, village, or post office
(no. and street or rural route)
School district
code number
State
ZIP code
Country
Taxpayer’s date of death Spouse’s date of death
(if not United States)
Decedent
information
New York City part-year residents only
E
A Filing
Single
(1) Number of months you lived in NY City in 2014 ....
status
Married filing joint return
(mark an
(2) Number of months your spouse lived
(enter both spouses’ social security numbers above)
X in one
in NY City in 2014 ..................................................
Married filing separate return
box):
Enter your 2-character special condition code
F
(enter both spouses’ social security numbers above)
if applicable
........................................
(see instructions)
Head of household
(with qualifying person)
If applicable, also enter your second 2-character
special condition code ...................................................
Qualifying widow(er) with dependent child
New York State part-year residents
G
Did you itemize your deductions on
B
Enter the date you moved into
your 2014 federal income tax return? ............. Yes
No
.......................
or out of NYS
(mm-dd-yyyy)
C
Can you be claimed as a dependent
On the last day of the tax year
:
(mark an X in one box)
on another taxpayer’s federal return? ............. Yes
No
D1
1) Lived in NYS ...................................................................
Did you file an amended federal
2) Lived outside NYS; received income from
return?
.................................. Yes
No
(see instructions)
NYS sources during nonresident period .........................
D2
Yonkers residents and Yonkers part-year residents only
3) Lived outside NYS; received no income from
(1) Did you receive a property tax
NYS sources during nonresident period .........................
freeze credit? .......................................... Yes
No
(2) If Yes, enter
.
the amount ..............
00
H
New York State nonresidents
Did you or your spouse maintain
D3
living quarters in NYS in 2014? ...................Yes
No
Did you receive a family tax relief credit? ...... Yes
No
(if Yes, complete Form IT-203-B)
I
Dependent exemption information
First name and middle initial
Last name
Relationship
Social security number
Date of birth
(mm-dd-yyyy)
363001140094
If more than 6 dependents, mark an X in the box.

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