Form It-250 - Claim For Credit For Purchase Of An Automated External Defibrillator - 2013

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New York State Department of Taxation and Finance
IT-250
Claim for Credit for Purchase of an
Automated External Defibrillator
Personal Income Tax
Submit this form with Form IT-201, IT-203, IT-204, or IT-205.
Identification number on return
Name(s) as shown on return
Type of business
(if applicable)
Complete this form if you are claiming a credit for the purchase of an automated external defibrillator.
Schedule A – Individuals, including sole proprietors, partnerships, and estates or trusts
Use a separate line for each defibrillator purchased. If you need more lines, submit additional Form(s) IT‑250 and enter the total from all
.
additional forms on line 1
(see instructions)
A
B
C
D
E
Credit
Date purchased
(enter the lesser
Defibrillator name/model number
Cost
Maximum credit
of column C or column D)
(mm-dd-yyyy)
.
.
$500
00
00
.
.
$500
00
00
.
.
$500
00
00
.
.
$500
00
00
.
.
$500
00
00
1 Total column E amounts from additional Form(s) IT‑250, if any ........................................................
.
1
00
........................................................
.
2 Total credit
2
(add column E amounts, including any amount on line 1)
00
Fiduciaries: Include the line 2 amount on the Total line of Schedule D, column C.
All others: Enter the line 2 amount on Schedule E, line 7.
Schedule B – Partnership, S corporation, and estate or trust information
(see instructions)
If you were a partner in a partnership, a shareholder of a New York S corporation, or a beneficiary of an estate or trust and received a
share of the credit for the purchase of an automated external defibrillator from that entity, complete the following information for each
partnership, S corporation, or estate or trust. For Type enter P for partnership, S for S corporation, or ET for estate or trust.
Name
Type
Employer identification number
250001130094

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