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Form Pit-S - New Mexico Supplemental Schedule For Dependent Exemptions In Excess Of Five - 2011

2011 PIT-S DEPENDENT EXEMPTIONS

*110260200*

NEW MEXICO SUPPLEMENTAL SCHEDULE FOR

DEPENDENT EXEMPTIONS IN EXCESS OF FIVE

YOUR SOCIAL SECURITY NUMbER

Print your name (first, middle, last)

Use Schedule PIT-S ONLY if you have more than five federal qualifying dependent exemptions. If you have more

than five federal dependent exemptions, enter the name, social security number, and date of birth of the first five

qualifying dependents on line 5 of 2011 Form PIT-1. Enter the name, social security number, and date of birth of the

remaining qualifying dependents on 2011 Schedule PIT-S and attach the Schedule PIT-S to your 2011 New Mexico

Personal Income Tax Return. Enter only qualifying dependent exemptions allowed on your federal return. You

do not need to include yourself or your spouse if filing a joint return. New Mexico uses the same definitions and

qualifications as the Internal Revenue Service to determine if someone is a qualified dependent. See the instruc-

tions for Federal Form 1040, 1040A or 1040EZ to determine who you may claim as a dependent exemption or visit

the IRS website at

Line 5. Form 2011 PIT-1. DEPENDENTS continued. Enter the names as listed on the federal form.

Name

Social security number

Date of birth

10.

11.

12.

13.

14.

15.

16.

18.

19.

20.

If you need additional space, attach multiple Schedules PIT-S.

Schedule PIT-S must be attached to Form PIT-1 or your additional exemptions will be denied.

Form Pit-S - New Mexico Supplemental Schedule For Dependent Exemptions In Excess Of Five - 2011