Form It-2104 - Employee'S Withholding Allowance Certificate - 2009 Page 2

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IT-2104 (4/09) Page 3 of 4

Worksheet

Part 1 — Complete this part to compute your withholding allowances for New York State and Yonkers

(line 1)

6 Enter the number of dependents that you will claim on your state return (do not include yourself or, if married, your spouse) ... 6.

For lines 7, 8, and 9, enter 1 for each credit you expect to claim on your state return.

7 College tuition credit ................................................................................................................................................................... 7.

8 New York State household credit ................................................................................................................................................ 8.

9 Real property tax credit ............................................................................................................................................................... 9.

For lines 10, 11, and 12, enter 3 for each credit you expect to claim on your state return.

10 Child and dependent care credit ................................................................................................................................................ 10.

11 Earned income credit ................................................................................................................................................................ 11.

12 Empire State child credit ........................................................................................................................................................... 12.

13 Other credits

..................................................................................................................................................... 13.

(see instructions)

For lines 14 and 15, enter 2 if either situation applies.

14 Head of household status and only one job .............................................................................................................................. 14.

15 Married couples with only one spouse working and only one job ............................................................................................. 15.

16 Enter an estimate of your federal adjustments to income, such as alimony you will pay for the tax year

and deductible IRA contributions you will make for the tax year. Total estimate $

Divide this estimate by $1,000. Drop any fraction and enter the number ............................................................................... 16.

17 If you expect to itemize deductions on your state tax return, complete Part 2 below and enter the number from line 28.

All others enter 0 .................................................................................................................................................................... 17.

18 Add lines 6 through 17 ............................................................................................................................................................... 18.

19 If you have more than one job, or are married with both spouses working, and your combined wages are between

$100,000 and $1,100,000, enter the appropriate number from one of the charts in Part 4. All others enter 0 ..................... 19.

20 Subtract line 19 from line 18. Enter the result, including negative amounts, here and on line 1. If your employer cannot

accommodate negative allowances, enter 0 here and on line 1 and see Additional dollar amounts in the instructions.

(If you have more than one job, or if you and your spouse both work, see instructions.) ....................................................... 20.

Part 2 — Complete this part only if you expect to itemize deductions on your state return.

21 Enter your estimated federal itemized deductions for the tax year............................................................................................ 21.

22 Enter your estimated state, local, and foreign income taxes included on line 21

(if your estimated New York AGI is over $1 million,

. ......................... 22.

you must enter on line 22 all estimated federal itemized deductions included on line 21 except charitable contributions)

23 Subtract line 22 from line 21 ..................................................................................................................................................... 23.

24 Enter your estimated college tuition itemized deduction ........................................................................................................... 24.

25 Add lines 23 and 24 .................................................................................................................................................................. 25.

26 Based on your federal filing status, enter the applicable amount from the table below ............................................................. 26.

Standard deduction table

Single (cannot be claimed as a dependent) ... $ 7,500

Qualifying widow(er) ......................................... $15,000

Single (can be claimed as a dependent) ........ $ 3,000

Married filing jointly ........................................... $15,000

Head of household .......................................... $10,500

Married filing separate returns .......................... $ 7,500

27 Subtract line 26 from line 25

........................................................ 27.

(if line 26 is larger than line 25, enter 0 here and on line 17 above)

28 Divide line 27 by $1,000. Drop any fraction and enter the result here and on line 17 above .................................................... 28.

Part 3 — Complete this part to compute your withholding allowances for New York City

(line 2)

29 Enter the amount from line 6 above .......................................................................................................................................... 29.

30 Add lines 14 through 17 above and enter total here ................................................................................................................. 30.

31 Add lines 29 and 30. Enter the result here and on line 2........................................................................................................... 31.

(continued on page 4)