Form It-213 - Claim For Empire State Child Credit - 2014
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2IT-213
New York State Department of Taxation and Finance
Claim for Empire State Child Credit
Submit this form with Form IT-201 or IT-203.
Step 1 – Enter identifying information
Your name as shown on return
Your social security number
Spouse’s name
Spouse’s social security number
Step 2 – Determine eligibility
1 Were you (and your spouse if filing a joint New York State return) New York State residents for all of 2014?
1
Yes
No
If you marked an X in the No box, stop; you do not qualify for this credit.
2 Did you claim the federal child tax credit or additional child tax credit for 2014? .......................................
2
Yes
No
3 Is your federal adjusted gross income
(see instructions)
–
$110,000 or less and your filing status is married filing joint return;
–
$75,000 or less and your filing status is single, head of household, or qualifying widow(er); or
–
$55,000 or less and your filing status is married filing separate return? ..........................................
3
Yes
No
If you marked an X in the No box at both lines 2 and 3, stop; you do not qualify for this credit.
4 Enter the number of children who qualify for the federal child tax credit or
additional child tax credit
...............................................................................................
4
(see instructions)
5 Enter the number of children from line 4 that were at least four but less than 17 years of age on December 31, 2014 ..
5
If you entered 0 on line 5, stop; you do not qualify for this credit.
Step 3 – Enter child information
List below the name, social security number, and date of birth for each child included on line 4.
Date of birth
First name
MI
Last name
Social security number
(mmddyyyy)
Use Form IT-213-ATT if you have additional children to report
(see instructions).
213001140094
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