Form It-201 - Resident Income Tax Return - 2012 Page 4
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4Page 4 of 4 IT-201 (2012)
Your social security number
.
62 Enter amount from line 61 ........................................................................................................... 62
00
Payments and refundable credits (see page 31)
.
63 Empire State child credit ................................................... 63
00
64 NYS/NYC child and dependent care credit ....................... 64
.
00
.
65 NYS earned income credit (EIC) ................................
65
00
.
66 NYS noncustodial parent EIC ............................................ 66
00
.
67 Real property tax credit ..................................................... 67
00
.
68 College tuition credit .......................................................... 68
00
.
69 NYC school tax credit
69
(also complete F on page 1; see page 31)
00
.
70 NYC earned income credit ...........................................
70
00
.
71 Other refundable credits
.............. 71
(Form IT-201-ATT, line 18)
00
.
72 Total New York State tax withheld .................................... 72
Submit your wage and tax
00
statements with your return
.
73 Total New York City tax withheld ...................................... 73
00
(see page 33).
.
74 Total Yonkers tax withheld ................................................ 74
00
.
75 Total estimated tax payments and amount paid with Form IT-370 75
00
.
76 Total payments
...................................................................................... 76
(add lines 63 through 75)
00
Your refund, amount you owe, and account information (see pages 33 through 36)
.
77 Amount overpaid
................................. 77
(if line 76 is more than line 62, subtract line 62 from line 76)
00
78 Amount of line 77 to be refunded
direct
debit
paper
.
Mark one refund choice:
deposit
card
check ... 78
(fill in line 83) - or -
- or -
00
79 Amount of line 77 that you want applied to your
See pages 33 and 34 for
information about your three
.
2013 estimated tax
............................... 79
(see instructions)
00
refund choices.
80 Amount you owe (
).
if line 76 is less than line 62, subtract line 76 from line 62
.
To pay by electronic funds withdrawal, mark an X in the box
and fill in lines 83 and 84 ..
80
00
See page 37 for the proper
81 Estimated tax penalty
(include this amount in line 80 or
assembly of your return.
.
................. 81
reduce the overpayment on line 77; see page 34)
00
.
82 Other penalties and interest
......................... 82
(see page 35)
00
83 Account information for direct deposit or electronic funds withdrawal (
).
see page 35
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. 35)
83a Account type:
Personal checking
- or -
Personal savings - or -
Business checking
- or -
Business savings
83b Routing number
83c Account number
.
84 Electronic funds withdrawal
.............................
(see page 36)
Date
Amount
00
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.)
Preparer’s signature
Preparer’s NYTPRIN
Your signature
Firm’s name (or yours, if self-employed)
Preparer’s PTIN or SSN
Your occupation
Address
Employer identification number
Spouse’s signature and occupation (if joint return)
Mark an X if
Date
Daytime phone number
(
)
self-employed
E-mail:
E-mail:
201004120094
See instructions for where to mail your return.
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