Form It-203 - Nonresident And Part-Year Resident - 2012 Page 4
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4Page 4 of 4 IT-203 (2012)
Enter your social security number
.
59 Enter amount from line 58 ............................................................................................................ 59
00
Payments and refundable credits
(see page 38)
.
60 Part-year NYC school tax credit
...
60
(also complete E on front; see page 38)
00
.
61 Other refundable credits
...............
61
(Form IT-203-ATT, line 17)
00
Submit your wage and tax
.
62 Total New York State tax withheld .....................................
62
00
statements with your return
.
63 Total New York City tax withheld .......................................
63
00
(see page 38).
.
64 Total Yonkers tax withheld .................................................
64
00
.
65 Total estimated tax payments/amount paid with Form IT-370 ..
65
00
.
66 Total payments and refundable credits
............................................... 66
(add lines 60 through 65)
00
Your refund, amount you owe, and account information
(see pages 39 through 42)
.
67 Amount overpaid
.................................. 67
(if line 66 is more than line 59, subtract line 59 from line 66)
00
68 Amount of line 67 to be refunded
direct
debit
paper
.
Mark one refund choice:
deposit
card
check ...
68
(fill in line 73) - or -
- or -
00
69 Amount of line 67 that you want applied
See pages 39 and 40 for
.
information about your three
to your 2013 estimated tax
....................
69
(see instructions)
00
refund choices.
70 Amount you owe
.
(if line 66 is less than line 59, subtract line 66 from line 59)
.
To pay by electronic funds withdrawal, mark this box
and fill in lines 73 and 74 .............. 70
00
71 Estimated tax penalty
(include this amount on line 70,
See page 43 for the proper
.
............... 71
00
or reduce the overpayment on line 67; see page 40)
assembly of your return.
.
72 Other penalties and interest
72
(see page 40) ................................
00
73 Account information for direct deposit or electronic funds withdrawal
.
(see page 41)
If the funds for your payment (or refund) would come from (or go to) an account outside the U.S., mark an X in this box
(see pg. 41)
73a Account type:
Personal checking
- or -
Personal savings - or -
Business checking
- or -
Business savings
73b Routing number
73c Account number
.
74 Electronic funds withdrawal
00
(see page 41) ................................. Date
Amount
Print designee’s name
Designee’s phone number
Personal identification
Third-party
number (PIN)
designee?
(see instr.)
(
)
E-mail:
Yes
No
Date
Taxpayer(s) must sign here
Paid preparer must complete
(see instr.)
Your signature
Preparer’s signature
Preparer’s NYTPRIN
Your occupation
Firm’s name (or yours, if self-employed)
Preparer’s PTIN or SSN
Spouse’s signature and occupation (if joint return)
Address
Employer identification number
Daytime phone number
Date
Mark an X if
(
)
self-employed
E-mail:
E-mail:
See instructions for where to mail your return.
203004120094
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