28
(tips continued on the back) Updated 2/16/17 sh NEW YORK STATE Non-Resident Tax Information (Forms IT-203, IT-203-B, & IT-2): Due date April 18, 2017 You may use the SPRINTAX software to complete your New York State forms for a fee of $26 or use our instructions here. You may also access ALL of this information on our web site at: http://isso.cornell.edu/financial/taxes/new-york-state-tax-information You are required to file a New York State tax return if you are a New York State non-resident for tax purposes (see the back of this page) AND: New York State taxes were withheld from your income in 2016 and you want a refund, OR You received more than $7,950 in 2016 from a US source, AND some of that is from a New York source. If the above do not apply to you, you are not required to file a New York State tax return! **In order to file your New York State Tax forms, you need to first complete a federal non- resident tax form using the SPRINTAX software: http://www.isso.cornell.edu/financial/taxes Tips for the IT-203: These are not the only lines you will need to fill in, but these tips cover the usual questions people have. You should ALSO read and follow the Instruction Booklet available here: http://www.tax.ny.gov/pdf/current_forms/it/it203i.pdf 1. If you file US federal NON-resident tax forms (1040NR or 1040NR-EZ), you may NOT file your New York State forms electronically. 2. When filling out the state form, follow the amounts on your federal form as directed by our tips below and USE whole dollar amounts ONLY. 3. You must use black ink on your New York State form. 4. If you do not have a social security number or an ITIN, but you have filed an ITIN (W-7) application, then write “ITIN pending” at the upper right in the SSN box. 5. Leave the boxes for county and school code blank or write “NR.” 6. Fill in your mailing address in New York State in the mailing address section—and ALSO fill in your home country address in the permanent home address section 7. Line A: You may ONLY choose either filing status 1 “single” or 3 “married filing separately” 8. Line B: Answer “yes” ONLY if the software allowed you to itemize deductions on your federal return (line 11 on 1040NRez OR line 35 on 1040NR) 9. Line C: If you are a NON-resident for U.S. federal tax purposes, answer “No” 10. Line D1: Internationals filing as non-residents for federal tax purposes should check “No” 11. Line D2: Leave this blank [don’t answer yes or no]. 12. Line E, F, and G: leave blank. 13. Line H: Check “Yes” and fill out IT-203-B. Please note, you do NOT need to fill out the ENTIRE IT-203-B, but only your name and SSN at the top AND the part entitled, “Schedule B, Living quarters maintained in New York” (attached instructions page 42). 14. Line I—Dependent exemption information. ONLY fill this in if the GTP software allowed you to include dependents on your federal form—citizens of very few countries can do this. 15. LINE 1: Report wages from the wage line on your 1040NR line 8, or 1040NR-EZ line 3

NEW YORK STATE Non-Resident Tax Information … YORK STATE Non-Resident Tax Information (Forms IT-203, IT-203-B, & IT-2): Due date April 18, 2017 You may use the SPRINTAX software

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Page 1: NEW YORK STATE Non-Resident Tax Information … YORK STATE Non-Resident Tax Information (Forms IT-203, IT-203-B, & IT-2): Due date April 18, 2017 You may use the SPRINTAX software

(tips continued on the back) Updated 2/16/17 sh

NEW YORK STATE Non-Resident Tax Information (Forms IT-203, IT-203-B, & IT-2): Due date April 18, 2017

You may use the SPRINTAX software to complete your New York State forms for a fee of $26 or use our instructions here. You may also access ALL of this information on our web site at: http://isso.cornell.edu/financial/taxes/new-york-state-tax-information You are required to file a New York State tax return if you are a New York State non-resident for tax purposes (see the back of this page) AND: • New York State taxes were withheld from your income in 2016 and you want a refund, OR • You received more than $7,950 in 2016 from a US source, AND some of that is from a New

York source.

If the above do not apply to you, you are not required to file a New York State tax return! **In order to file your New York State Tax forms, you need to first complete a federal non-resident tax form using the SPRINTAX software: http://www.isso.cornell.edu/financial/taxes Tips for the IT-203: These are not the only lines you will need to fill in, but these tips cover the usual questions people have. You should ALSO read and follow the Instruction Booklet available here: http://www.tax.ny.gov/pdf/current_forms/it/it203i.pdf 1. If you file US federal NON-resident tax forms (1040NR or 1040NR-EZ), you may NOT file your

New York State forms electronically. 2. When filling out the state form, follow the amounts on your federal form as directed by our tips

below and USE whole dollar amounts ONLY. 3. You must use black ink on your New York State form. 4. If you do not have a social security number or an ITIN, but you have filed an ITIN (W-7)

application, then write “ITIN pending” at the upper right in the SSN box. 5. Leave the boxes for county and school code blank or write “NR.” 6. Fill in your mailing address in New York State in the mailing address section—and ALSO

fill in your home country address in the permanent home address section 7. Line A: You may ONLY choose either filing status 1 “single” or 3 “married filing separately” 8. Line B: Answer “yes” ONLY if the software allowed you to itemize deductions on your federal

return (line 11 on 1040NRez OR line 35 on 1040NR) 9. Line C: If you are a NON-resident for U.S. federal tax purposes, answer “No” 10. Line D1: Internationals filing as non-residents for federal tax purposes should check “No” 11. Line D2: Leave this blank [don’t answer yes or no]. 12. Line E, F, and G: leave blank. 13. Line H: Check “Yes” and fill out IT-203-B. Please note, you do NOT need to fill out the ENTIRE

IT-203-B, but only your name and SSN at the top AND the part entitled, “Schedule B, Living quarters maintained in New York” (attached instructions page 42).

14. Line I—Dependent exemption information. ONLY fill this in if the GTP software allowed you to include dependents on your federal form—citizens of very few countries can do this.

15. LINE 1: Report wages from the wage line on your 1040NR line 8, or 1040NR-EZ line 3

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Updated 2/16/17 sh

16. LINE 4: If you reported your last year state refund on the federal form, enter it on line 4 (1040NR line 11; 1040NR-EZ line 4)

17. Report fellowships and grants (on 1042-S or 1099) on Line 16 and identify (if you have a 1042-S and the exemption code in box 6 is “00,” then this income is fellowship or grants.

18. You should leave off any treaty exempt income that is reported on a 1042-S (exemption code in box 4a would be “04”)—you do NOT have to report it anywhere on the NY state form.

19. If you have treaty exempt income that was incorrectly included on your W-2 as taxable wage income, but was correctly recorded as treaty exempt on your federal tax form, you should send a copy of your federal tax form to show that the income is treaty exempt.

20. Line 19 MUST equal the federal adjusted gross income on Form 1040NREZ or 1040NR. 21. Line 33. Enter your Standard Deduction -- $7950 22. Line 38: Figure the tax on your taxable income from the tax table (page 55-62 attached). 23. Line 39: Household credit—most people CAN take this (page 29-30 attached). 24. Line 45: If you only received income from a New York State source, Line 45 will equal 1. 25. Line 56: Sales and use tax— don’t leave blank! (can be 0)! See instructions (page 32 attached). 26. Line 62: Report how much state tax was withheld from you from your W-2 and / or 1042-S 27. Lines 67-74: Figure how much you owe or are owed and how you will pay or receive that amount. 28. IT-2: Transfer all of the information from your W-2 forms to the IT-2 forms according to the

directions on the back of the IT-2 (every box from the W-2 has a corresponding box on the IT-2). 29. Putting it all together: Follow the instructions on pages 37-40 attached to this packet on how to

make payments if required and how put together and mail your forms.

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203001160094

Department of Taxation and Finance

Nonresident and Part-Year ResidentIncome Tax Return New York State • New York City • Yonkers • MCTMT

IT-203

E New York City part-year residents only (see page 15)

(1) Number of months you lived in NY City in 2016 .....

(2) Number of months your spouse lived in NY City in 2016 ....................................................

F Enter your 2-character special condition code(s) if applicable (see page 15) ...............

G New York State part-year residents (see page 16)

Enter the date you moved into or out of NYS (mmddyyyy) ......................... On the last day of the tax year (mark an X in one box): 1) Lived in NYS ................................................................... 2) Lived outside NYS; received income from NYS sources during nonresident period .........................

3) Lived outside NYS; received no income from NYS sources during nonresident period .........................

H New York State nonresidents (see page 16)

Did you or your spouse maintain living quarters in NYS in 2016? ...................Yes No (if Yes, complete Form IT-203-B)

c Single

d Married ¿ling Moint return (enter both spouses’ social security numbers above)

e Married ¿ling separate return (enter both spouses’ social security numbers above)

f Head of household (with qualifying person)

g Qualifying widow(er) with dependent child

A Filing status (mark an X in one box):

B Did you itemize your deductions on your 2016 federal income tax return? .........................................Yes No

C Can you be claimed as a dependent on another taxpayer’s federal return? ..........................................Yes No

D1 Did you have a ¿nancial account located in a foreign country? (see page 15) ...................................Yes No

D2 Yonkers part-year residents only: (1) Did you receive a property tax freeze or property tax relief credit? (see page 15) .................................................. Yes No

(2) If Yes, enter the total amount ........... .00

Taxpayer’s date of death Spouse’s date of death

School district code number

Decedentinformation

Taxpayer’s permanent home address (see instr., pg. 14) (no. and street or rural route) $partment no. City, village, or post of¿ce

State ZIP code Country (if not United States)

Your social security number

Spouse’s social security number

For help completing your return, see the instructions, Form IT-203-I.Your ¿rst name and middle initial Your last name (for a joint return, enter spouse’s name on line below) Your date of birth (mmddyyyy)

Spouse’s ¿rst name and middle initial Spouse’s last name Spouse’s date of birth (mmddyyyy)

Mailing address (see instructions, page 14) (number and street or PO box) Apartment number

City, village, or post of¿ce State ZIP code Country (if not United States)

New York State county of residence

School district name

First name and middle initial Last name Relationship Social security number Date of birth (mmddyyyy)

I Dependent exemption information (see page 16)

If more than 6 dependents, mark an X in the box.

� )RU�WKH�\HDU�-DQXDU\����������WKURXJK�'HFHPEHU�����������RU�¿VFDO�\HDU�EHJLQQLQJ ........... 1 6 and ending ...........

For of¿ce use only

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203002160094

Page 2 of 4 IT-203 (2016)

24 Taxable refunds, credits, or offsets of state and local income taxes (from line 4) ...................................... 24 .00 24 .0025 Pensions of NYS and local governments and the federal government (see page 26) .................................. 25 .00 25 .0026 Taxable amount of social security bene¿ts (from line 15) ... 26 .00 26 .0027 Interest income on U.S. government bonds ..................... 27 .00 27 .0028 Pension and annuity income exclusion ............................ 28 .00 28 .0029 Other (Form IT-225, line 18) .................................................. 29 .00 29 .0030 Add lines 24 through 29 ................................................... 30 .00 30 .0031 New York adjusted gross income (subtract line 30 from line 23) 31 .00 31 .00

32 Enter the amount from line 31, Federal amount column ............................................................. 32 .00

New York subtractions (see page 26)

33 Enter your standard deduction (table on page 28) or your itemized deduction (from Form IT-203-D). Mark an X in the appropriate box: ... Standard – or – Itemized 33 .0034 Subtract line 33 from line 32 (if line 33 is more than line 32, leave blank) ........................................... 34 .00 35 Dependent exemptions (enter the number of dependents listed in Item I; see page 28) ......................... 35 000.00 36 New York taxable income (subtract line 35 from line 34) ................................................................ 36 .00

Enter your social security number

20 Interest income on state and local bonds and obligations (but not those of New York State or its localities) .................. 20 .00 20 .0021 Public employee 414(h) retirement contributions ............. 21 .00 21 .0022 Other (Form IT-225, line 9) .................................................... 22 .00 22 .0023 Add lines 19 through 22 .................................................... 23 .00 23 .00

New York additions (see page 25)

Federal amount Whole dollars only

1 Wages, salaries, tips, etc. ................................................. 1 .00 1 .00 2 Taxable interest income .................................................... 2 .00 2 .00 3 Ordinary dividends ............................................................ 3 .00 3 .00 4 Taxable refunds, credits, or offsets of state and local income taxes (also enter on line 24) ................................ 4 .00 4 .00 5 Alimony received .............................................................. 5 .00 5 .00 6 Business income or loss (submit a copy of federal Sch. C or C-EZ, Form 1040) 6 .00 6 .00 7 Capital gain or loss (if required, submit a copy of federal Sch. D, Form 1040) 7 .00 7 .00 8 Other gains or losses (submit a copy of federal Form 4797) .. 8 .00 8 .00 9 Taxable amount of IRA distributions. Bene¿ciaries: mark X in box 9 .00 9 .0010 Taxable amount of pensions�annuities. Bene¿ciaries: mark X in box 10 .00 10 .0011 Rental real estate, royalties, partnerships, S corporations, trusts, etc. (submit a copy of federal Schedule E, Form 1040) 11 .00 11 .00 12 Rental real estate included in line 11 (federal amount) 12 .00 13 Farm income or loss (submit a copy of federal Sch. F, Form 1040) 13 .00 13 .0014 Unemployment compensation ........................................... 14 .00 14 .0015 Taxable amount of social security bene¿ts (also enter on line 26) 15 .00 15 .0016 Other income (see page 23) Identify: 16 .00 16 .0017 Add lines 1 through 11 and 13 through 16 ..................... 17 .00 17 .0018 Total federal adMustments to income (see page 23) Identify: 18 .00 18 .0019 Federal adjusted gross income (subtract line 18 from line 17) 19 .00 19 .00

Federal income and adjustments New York State amount

Whole dollars only(see page 17)

Standard deduction or itemized deduction (see page 28)

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203003160094

New York City and Yonkers taxes, credits, and surcharges, and MCTMT

IT-203 (2016) Page 3 of 4

Voluntary contributions (see page 33)

Name(s) as shown on page 1 Enter your social security number

57 Total voluntary contributions (add lines 57a through 57n) ............................................................ 57 .0058 Total New York State, New York City, Yonkers, and sales or use taxes, MCTMT, and voluntary contributions (add lines 50, 55, 56, and 57) ........................................................ 58 .00

37 New York taxable income (from line 36 on page 2) ......................................................................... 37 .0038 New York State tax on line 37 amount (see page 29) ..................................................................... 38 .00 39 New York State household credit (page 29, table 1, 2, or 3) .............................................................. 39 .0040 Subtract line 39 from line 38 (if line 39 is more than line 38, leave blank) ............................................ 40 .00 41 New York State child and dependent care credit (see page 30) ..................................................... 41 .0042 Subtract line 41 from line 40 (if line 41 is more than line 40, leave blank) ............................................ 42 .00 43 New York State earned income credit (see page 30) ..................................................... 43 .00

44 Base tax (subtract line 43 from line 42; if line 43 is more than line 42, leave blank) ................................. 44 .00

45 Income New York State amount from line 31 Federal amount from line 31 Round result to 4 decimal places percentage .00 ÷ .00 = 45

(see page 30)

46 Allocated New York State tax (multiply line 44 by the decimal on line 45) ........................................... 46 .00 47 New York State nonrefundable credits (Form IT-203-ATT, line 8) ..................................................... 47 .00 48 Subtract line 47 from line 46 (if line 47 is more than line 46, leave blank) ........................................... 48 .00 49 Net other New York State taxes (Form IT-203-ATT, line 33) ............................................................. 49 .00 50 Total New York State taxes (add lines 48 and 49) ......................................................................... 50 .00

51 Part-year New York City resident tax (Form IT-360.1) ....... 51 .00 52 Part-year resident nonrefundable New York City child and dependent care credit .................................. 52 .0052a Subtract line 52 from 51 .................................................. 52a .00 52b MCTMT net earnings base .... 52b .00 52c MCTMT ............................................................................ 52c .00 53 Yonkers nonresident earnings tax (Form Y-203) ............... 53 .00 54 Part-year Yonkers resident income tax surcharge (Form IT-360.1) .............................................................. 54 .00 55 Total New York City and Yonkers taxes / surcharges and MCTMT (add lines 52a, and 52c through 54) 55 .00

56 Sales or use tax (See the instructions on page 32. Do not leave line 56 blank.) .............................. 56 .00

See instructions on pages 30 and 31 to compute New York City and Yonkers taxes, credits, and surcharges, and MCTMT.

Tax computation, credits, and other taxes

57a Return a Gift to Wildlife ................................................................ 57a .00 57b Missing/Exploited Children Fund ................................................. 57b .00 57c Breast Cancer Research Fund .................................................... 57c .00 57d Alzheimer’s Fund ......................................................................... 57d .00 57e Olympic Fund ($2 or $4) ................................................................ 57e .00 57f Prostate and Testicular Cancer Research and Education Fund .. 57f .00 57g 9/11 Memorial .............................................................................. 57g .00 57h 9olunteer Fire¿ghting EMS Recruitment Fund .......................... 57h .00 57i Teen Health Education ................................................................. 57i .00 57j Veterans Remembrance ............................................................... 57j .00 57k Homeless Veterans ....................................................................... 57k .00 57l Mental Illness Anti-Stigma Fund .................................................. 57l .00 57m Women’s Cancers Education and Prevention Fund .................... 57m .00 57n Autism Fund ................................................................................. 57n .00

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203004160094

Your signature

Your occupation

Spouse’s signature and occupation (if joint return)

Date Daytime phone number

E-mail:

60 Part-year NYC school tax credit (also complete E on front; see page 34) ... 60 .00 61 Other refundable credits (Form IT-203-ATT, line 17) ............... 61 .00 62 Total New York State tax withheld ..................................... 62 .00 63 Total New York City tax withheld ....................................... 63 .00 64 Total Yonkers tax withheld ................................................. 64 .00 65 Total estimated tax payments/amount paid with Form IT-370 .. 65 .00 66 Total payments and refundable credits (add lines 60 through 65) ............................................... 66 .00

Payments and refundable credits (see page 34)

59 Enter amount from line 58 ............................................................................................................ 59 .00

If applicable, complete Form(s) IT-2 and/or IT-1099-R and submit them with your return (see page 12).Do not send federal Form W-2 with your return.

67 Amount overpaid (if line 66 is more than line 59, subtract line 59 from line 66) .................................. 67 .00 68 Amount of line 67 to be refunded direct paper Mark one refund choice: deposit (¿ll in line 73) - or - check ................................. 68 .00

69 Amount of line 67 that you want applied to your 2017 estimated tax (see instructions) .................... 69 .0070 Amount you owe (if line 66 is less than line 59, subtract line 66 from line 59). To pay by electronic funds withdrawal, mark an X in the box and ¿ll in lines 73 and 74. If you pay by check or money order you must complete Form IT-201-V and mail it with your return. ...................... 70 .0071 Estimated tax penalty (include this amount on line 70, or reduce the overpayment on line 67; see page 36) ............... 71 .0072 Other penalties and interest (see page 37) ................................ 72 .00

73 Account information for direct deposit or electronic funds withdrawal (see page 37).

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. 37)

See instructions for where to mail your return.

Refund? Direct deposit is the easiest, fastest way to get your refund.See page 37 for payment options.

Enter your social security number

See page 40 for the proper assembly of your return.

Your refund, amount you owe, and account information (see pages 36 through 38)

73a Account type: Personal checking - or - Personal savings - or - Business checking - or - Business savings

73b Routing number 73c Account number

74 Electronic funds withdrawal (see page 38) ................................. Date Amount .00

Page 4 of 4 IT-203 (2016)

Print designee’s name Designee’s phone number Personal identi¿cation ( ) number (PIN)

E-mail:

Third-partydesignee? (see instr.)

Yes No

ź Taxpayer(s) must sign here ź

( )

ź Paid preparer must complete ź (see instructions)

Preparer’s NYTPRIN NYTPRIN excl. code

Preparer’s signature Preparer’s printed name

Firm’s name (or yours, if self-employed) Preparer’s PTIN or SSN

Address Employer identi¿cation number

Date

E-mail:

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234001160094

Department of Taxation and Finance

Nonresident and Part-Year Resident Income Allocation And College Tuition Itemized Deduction Worksheet

Name(s) and occupation(s) as shown on Form IT-203 Your social security number

Complete all parts that apply to you; see instructions (Form IT-203-I). Submit this form with your Form IT-203.

Schedule A – Allocation of wage and salary income to New York State

Nonworkingdays included

in line 1a:

Mark an X in the box if NYS living quarters were maintained for you or by you for the entire tax year .................................................

If you or your spouse maintained living quarters in NYS during any part of the year, give address(es) below. Submit additional

sheets if necessary. For column E, mark an X in the box if the living quarters are still maintained for or by you.

A – Street address B – City, village, or post office C D – ZIP code E

NY

NY

NY

NY

Enter the number of days spent in New York State in this tax year ..... Any part of a day spent in New York State is

considered a day spent in New York State.

IT-203-B

1a Total days (see instructions) ............................................................................................................................................... 1a 1b Saturdays and Sundays (not worked) .................................................................... 1b 1c Holidays (not worked) ............................................................................................ 1c 1d Sick leave ............................................................................................................. 1d 1e Vacation ............................................................................................................... 1e 1f Other nonworking days ........................................................................................ 1f 1g Total nonworking days (add lines 1b through 1f) ................................................................................................................. 1g 1h Total days worked in year at this job (subtract line 1g from line 1a) ..................................................................................... 1h 1i Total days included in line 1h worked outside New York State ................................................................... 1i 1j Enter number of days worked at home included in line 1i amount ............................................................. 1j 1k Subtract line 1j from line 1i .............................................................................................................................................. 1k 1l Days worked in New York State (subtract line 1k from line 1h) ............................................................................................ 1l 1m Enter number of days from line 1h above ....................................................................................................................... 1m

1n Divide line 1l by line 1m; round the result to the fourth decimal place ................................................................ 1n

1o Wages, salaries, tips, etc. (to be allocated) ................................................................................. 1o .00

1p New York State allocated wage and salary income (multiply line 1n by line 1o) .............................. 1p .00

Include the line 1p amount on Form IT-203, line 1, in the New York State amount column.

Schedule B – Living quarters maintained in New York State by a nonresident

Complete a separate Schedule A for each job for which your wage and salary income is subject to allocation.

An additional Schedule A section is provided on the back of this form. If you are required to complete more than one Schedule A, total

the amounts from line p on all schedules and include this total on Form IT-203, line 1, in the New York State amount column.

Do not use this schedule for income based on the volume of business transacted. See the Schedule A instructions if:

• You had more than one job;

• You had a job for only part of the year; or

• You and your spouse each had a job that requires allocation.

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234002160094

IT-203-B (2016) (back) Enter your social security number

1 Are you claimed as a dependent on another taxpayer’s New York State tax return for this tax year? .... 1 Yes No

• If Yes, stop; you do not qualify for the college tuition itemized deduction.

• If No, continue. Complete lines A through H below for each eligible student for whom you paid qualified college tuition expenses. Use additional sheets if necessary.

Schedule C – College tuition itemized deduction worksheet (See the instructions for Schedule C.)

Schedule A – Allocation of wage and salary income to New York State

Nonworkingdays included

in line 2a:

1 – Student 1 2 – Student 2 3 – Student 3

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Eligible student’s name ..........................

Eligible student’s social security

number (SSN) ........................................

Is the student claimed as a dependent

on your NYS return? (see instructions) .....

EIN of college or university (see instr.) ....

Name of college or university (see instr.) ...

Were expenses for undergraduate

tuition? (see instructions) .............................

Amount of qualified college tuition expenses (see instructions) ......................

Enter the lesser of line G or 10,000 ......

A

B

C

D

E

F

G

H

2 College tuition itemized deduction (add line H, columns 1, 2, and 3; include amounts from any additional sheets). Also enter this amount on your itemized deduction schedule. ................................................................ 2 .00

2a Total days (see instructions) ............................................................................................................................................... 2a 2b Saturdays and Sundays (not worked) .................................................................... 2b 2c Holidays (not worked) ............................................................................................ 2c 2d Sick leave ............................................................................................................. 2d 2e Vacation ............................................................................................................... 2e 2f Other nonworking days ........................................................................................ 2f 2g Total nonworking days (add lines 2b through 2f) ................................................................................................................. 2g 2h Total days worked in year at this job (subtract line 2g from line 2a) ..................................................................................... 2h 2i Total days included in line 2h worked outside New York State ................................................................... 2i 2j Enter number of days worked at home included in line 2i amount ............................................................. 2j 2k Subtract line 2j from line 2i .............................................................................................................................................. 2k 2l Days worked in New York State (subtract line 2k from line 2h) ............................................................................................ 2l 2m Enter number of days from line 2h above ....................................................................................................................... 2m

2n Divide line 2l by line 2m; round the result to the fourth decimal place ................................................................ 2n

2o Wages, salaries, tips, etc. (to be allocated) ................................................................................. 2o .00

2p New York State allocated wage and salary income (multiply line 2n by line 2o) .............................. 2p .00

Include the line 2p amount on Form IT-203, line 1, in the New York State amount column.

.00 .00 .00

.00 .00 .00

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102001160094

N Y

N Y

IT-2Department of Taxation and Finance

Summary of W-2 StatementsNew York State • New York City • Yonkers

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.00Box 12c� $PRXQW� � &RGH

.00Box 12d� $PRXQW� � &RGH

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.00Box 12b� $PRXQW� � &RGH

.00Box 12c� $PRXQW� � &RGH

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Box 1 Wages, tips, other compensation

.00Box 8 Allocated tips

.00Box 10� 'HSHQGHQW�FDUH�EHQH¿WV

.00Box 11 1RQTXDOL¿HG�SODQV

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Box 1 Wages, tips, other compensation

.00Box 8 Allocated tips

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W-2 Record 1

W-2 Record 2

Employer’s name

Employer’s name

Box c Employer’s information

Box c Employer’s information

Employer’s address (number and street)

Employer’s address (number and street)

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&LW\� 6WDWH� =,3�FRGH� &RXQWU\�(if not United States)

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Box a Employee’s VRFLDO�VHFXULW\�QXPEHU�for this W-2 Record

Box a Employee’s VRFLDO�VHFXULW\�QXPEHU�for this W-2 Record

Box 16b 2WKHU�VWDWH�ZDJHV��WLSV��HWF��� Box 17b 2WKHU�VWDWH�LQFRPH�WD[�ZLWKKHOG

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Box 16b 2WKHU�VWDWH�ZDJHV��WLSV��HWF��� Box 17b 2WKHU�VWDWH�LQFRPH�WD[�ZLWKKHOG

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Box 15a1<�6WDWH

Box 15a1<�6WDWH

Box 15bother state

Box 15bother state

Box 18 /RFDO�ZDJHV��WLSV��HWF�� � �Box 19 /RFDO�LQFRPH�WD[�ZLWKKHOG� � �Box 20 Locality name

Locality a .00 Locality a .00 Locality a

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Box 18 /RFDO�ZDJHV��WLSV��HWF�� � �Box 19 /RFDO�LQFRPH�WD[�ZLWKKHOG� � �Box 20 Locality name

Locality a .00 Locality a .00 Locality a

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Box 13 6WDWXWRU\�HPSOR\HH

Box 13 6WDWXWRU\�HPSOR\HH

Retirement plan

Retirement plan

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