Form Ct-249 - Claim For Long-Term Care Insurance Credit - 2013
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1
2CT-249
New York State Department of Taxation and Finance
Claim for Long-Term
Care Insurance Credit
Tax Law — Article 9, Article 9-A, Article 32, and Article 33
All filers must enter tax period:
beginning
ending
Legal name of corporation
Employer identification number
File this form with Form(s) CT-183, CT-184, CT-185, CT-186, CT-186-E, CT-186-P, CT-3, CT-3-A, CT-3-S,
CT-32, CT-32-A, CT-32-S, CT-33, CT-33-A, or CT-33-NL
Computation of available long-term care insurance credit
(New York S corporations, see instructions)
1 Qualified long-term care insurance premiums paid during the current tax year ...............................
1
2 Multiply line 1 by 20% (.2) .................................................................................................................
2
3 Long-term care insurance credit from partnership(s)
.................................
3
(from line 13; see instructions)
4 Unused long-term care insurance credit from preceding period ......................................................
4
5 Total available long-term care insurance credit
5
.................................................
(add lines 2, 3, and 4)
Computation of long-term care insurance credit limitation
6 Tax due before credits
............................................
6
(see instructions)
7 Enter other credits claimed before the long-term care insurance
credit
..................................................................
7
(see instructions)
8 Net tax
.......................................................
8
(subtract line 7 from line 6)
9 Minimum tax limitation
9
............................................
(see instructions)
10 Long-term care insurance credit limitation
(subtract line 9 from line 8;
................................................
10
if line 9 is greater than line 8, enter 0)
Computation of long-term care insurance credit used and available for carryforward
11 Long-term care insurance credit to be used for the current tax year
11
......................
(see instructions)
12 Long-term care insurance credit to be carried forward
...........................
12
(subtract line 11 from line 5)
Partnership information
(see the instructions for line 3; attach additional sheets if necessary)
Name of partnership
Identifying number
Amount of credit
Total from additional sheet(s), if any
...............................................................................................................
13 Total credit amount allocated from partnership(s)
13
(enter here and on line 3) ...............................
A If you are claiming this credit as a corporate partner, mark an X in the box ......................................................................................
497001130094
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