Form It-112-R - New York State Resident Credit - 2013

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New York State Department of Taxation and Finance
IT-112-R
New York State Resident Credit
Complete this form if you want to claim a resident credit for taxes paid to another state, local government, or the District of Columbia.
Name(s) as shown on return
Identifying number as shown on return
Submit this form with Form IT-201, IT-203, or IT-205. Failure to do so will delay any refund to which you may be entitled or, if
you owe taxes, could result in late-filing penalties.
A
B
Amount reported on
Amount sourced to and taxed
Part 1 – Income and adjustments
(see instructions)
New York State return
by other taxing authority
Whole dollars only
Whole dollars only
1 Wages, salaries, tips, etc. ................................................
00
00
.
.
1
1
2 Taxable interest income....................................................
00
00
.
.
2
2
3 Ordinary dividends ...........................................................
00
00
.
.
3
3
4 Taxable refunds, credits, or offsets of state and local
income taxes.................................................................
00
00
.
.
4
4
5 Alimony received ..............................................................
00
00
.
.
5
5
6 Business income or loss...................................................
00
00
.
.
6
6
7 Capital gain or loss ...........................................................
00
00
.
.
7
7
8 Other gains or losses .......................................................
00
00
.
.
8
8
9 Taxable amount of IRA distributions .................................
00
00
.
.
9
9
10 Taxable amount of pensions and annuities ...................... 10
00
00
.
.
10
11 Rental real estate, royalties, partnerships,
S corporations, trusts, etc. ............................................ 11
00
00
.
.
11
12 Farm income or loss ......................................................... 12
00
00
.
.
12
13 Unemployment compensation .......................................... 13
00
00
.
.
13
14 Taxable amount of social security benefits ....................... 14
00
00
.
.
14
15 Other income .................................................................... 15
00
00
.
.
15
16 Add lines 1 through 15 ..................................................... 16
00
00
.
.
16
17 Total federal adjustments to income ................................. 17
00
00
.
.
17
18 Federal adjusted gross income
............................................ 18
00
00
.
.
18
(subtract line 17 from line 16)
19 New York adjustments
............................ 19
00
.
19
(see instructions)
20 New York adjusted gross income
(line 18 and add or
....................................... 20
00
00
.
.
20
subtract line 19; see instructions)
21 Capital gain portion of lump-sum distributions
.. 21
00
00
.
.
21
(see instr.)
22 Add lines 20 and 21.......................................................... 22
00
00
.
.
22
(continued on back)
112001130094

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