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Click here or scroll down to respond to this candidate2021 IT-201 Filing InstructionsAUDIE A DE LA CRUZForm filed:IT-Street Address and supplemental forms and schedulesFiling method:Your return will be e-filed, do not mail your return Due date:04-18-2022Refund:$239.00Transaction method:If you choose to not have your refund directly deposited, a paper check will be mailed to you. Allow 4 to 8 weeks for your refund to be processed and mailed to you.2021New York State Income Tax Return Other New York and New York City Returns New York Return SummaryUnincorporated Business Tax (NYC-202)Advanced Payments ReceivedIncome, Adjustments and DeductionsLLC and LLP Filing FeeNonresident Employee of theCity of New York (NYC 1127)Tax, Payments, and CreditsMiscellaneous InformationTaxpayer SpouseAmount due or -refundAmount refundedOverpayment appliedTotal balance dueForm IT-204-LL, amount dueTaxable incomeMCTMT net earnings baseMCTMTRefundable Credits claimedTotal refundable creditsRefundOverpayment applied to next yearAmt as a NYS 529 account depositAmount refundedAmount due(Keep for your records)Daytime Phone #City State Zip EmailForm FiledFiling StatusNYS Residency Taxable incomeNYC Residency TaxYonkers Residency CreditsEstimate and extension paymentsProperty tax freeze creditUnderpayment of estimatesFederal adjusted gross income (FAGI) Failure to pay penalty FAGI (NYS Column - IT-203 filers) Failure to file penalty Total additions Late filing interestTotal SubtractionsNew York AGINY AGI (NYS Col - IT-203 filers)Itemized or standard deductionDependent ExemptionsTaxable incomeNew York State taxTaxNonrefundable state creditsCredits and withholdingsNet other state taxesBalance dueTotal NYS taxRefundNew York City taxesNew York City nonrefundable creditsYonkers taxesUse tax and contributions Empire State child credit (IT-213) Total tax and contributions NYS/NYC Child Dep (IT-216) NYS EIC (IT-215 or IT-209)NYS noncustodial EIC (IT-209)Income tax withheld NYC EIC IT-215 or IT-209)Estimate and extension payments Real property tax credit (IT-214) Total payments and credits College tuition credit (IT-272) Penalties and Interest NYC school tax credit (fixed amount) NYC school tax credit (rate reduction amount)Your social security numberNY_SUM.LDYour NameSpouse's Name Spouse's social security numberMailing address Apartment number...AUDIE A DE LA CRUZ 128 58 49751749 GRAND CONCOURSE 1Q PHONE NUMBER AVAILABLEBRONX NY 104538241 EMAIL AVAILABLEIT-201SINGLEFULL-YEAR RESIDENTRESIDENTNONRESIDENT0.52432.52432.X 8000.44432.2417.2417.1600.0.4017.63.4098.4256.63.239. 95.0.239.0.Office of Processing and Taxpayer ServicesW A Harriman Campus, Albany NY 12227-0865TR-573.2 (6/18)Department ofTaxation and FinanceMost tax return preparers are required to e-file their clients' New York State tax returns. Because this return was prepared using software, you MUST use e-file. If you file a paper New York State tax return, you will be in violation of New York State law.New York State law requires this return to be filed electronically. If your tax return preparer has provided you with a paper New York State tax return with instructions to mail it, contact that preparer and request that the return be electronically filed.No charge for e-filing: New York State Tax Law prohibits your tax preparer from charging you a separate or additional fee for e-filing your New York State tax return. Faster tax refunds: New York State tax refunds on e-filed returns are twice as fast as refunds on paper returns.Most New Yorkers enjoy the benefits of e-filing.Visit our website for more information about New York's e-file mandate. New York State requires this income tax return to be filed electronically. Preparers who file paper returns are subject to penalties. Avoid penalties and e-file this return.www.tax.ny.govAttention tax return preparer:Attention taxpayer:Questions?1024Your date of birth (mmddyyyy)Spouse's date of birth (mmddyyyy)Department of Taxation and Finance(see page 13)(enter spouse's Social Security number above)(see page 13)(enter spouse's Social Security number above) (1) Did you or your spouse maintain living quarters in NYC during 2021? (see page 13)(with qualifying person) (2) Enter the number of days spent in NYC in 2021(see page 13):(1) Number of months you lived in NYC in 2021(2) Number of t your spouse lived in NYC in 2021(see page 13)Date of birth (mmddyyyy)New York State New York City Yonkers MCTMTFor help completing your return, see the instructions, Form IT-201-I. A Filing D1statusD2EFBCGH Dependent information(mark anX in onebox):If more than 7 dependents, mark an X in the box.Resident Income Tax Return IT-201NYFor the full year January 1, 2021, through December 31, 2021, or fiscal year beginning ... 21 and ending ...NYC residents and NYC part-yearresidents onlycode(s) if applicableDid you have a financial account located in aSingle foreign country? Yes NoMarried filing joint return Were you required to report any nonqualified deferred compensation, as required by IRC 457A,on your 2021 federal return? Yes NoMarried filing separate returnYes NoHead of householdQualifying widow(er)Did you itemize your deductions onyour 2021 federal income tax return? Yes NoCan you be claimed as a dependenton another taxpayer's federal return? Yes NoEnter your 2-character special condition(see page 14)First name MI Last name Relationship Social Security number For office use onlyYour first name MI Your last name (for a joint return, enter spouse's name on line below) Your Social Security number Spouse's first name MI Spouse's last name Spouse's Social Security number Mailing address (see instructions, page 12) (number and street or PO Box) Apartment number New York State county of residence City, village, or post office State ZIP code Country School district name Taxpayer's permanent home address (see instructions, page 12) (number and street or rural route) Apartment number School districtcode numberCity, village, or post office State ZIP code Taxpayer's date of death (mmddyyyy) Spouse's date of death (mmddyyyy) Decedentinformation(1)(2)(3)(4)(any part of a day spent in NYC is considered a day)(5)...........NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM. AUDIE A DE LA CRUZ PHONE NUMBER AVAILABLE1749 GRAND CONCOURSE 1Q BRONXBRONX NY 10453 8241 BRONX068X XXX 12XPHONE NUMBER AVAILABLERental real estate, royalties, partnerships, S corporations, trusts, etc. (submit copy of federal Schedule E, Form 1040) Identify:Identify:(but not those of NYS or its local governments)Page 2 of 4 IT-201 (2021)Federal income and adjustments (see page 14)New York additions (see page 15)New York subtractions (see page 16)Standard deduction or itemized deduction (see page 19) 1 12 23 34 45 56 67 78 89 910 1011 1112 1213 1314 1415 1516 1617 1718 1819 1919a 19a20 2021 2122 2223 2324 2425 2526 2627 2728 2829 2930 3031 3132 3233 3334Standard - or - Itemized 3435 3536 36 000.0037 37Wages, salaries, tips, etc. .00Taxable interest income .00Ordinary dividends .00Taxable refunds, credits, or offsets of state and local income taxes (also enter on line 25) .00 Alimony received .00Business income or loss (submit a copy of federal Schedule C, Form 1040) .00 Capital gain or loss (if required, submit a copy of federal Schedule D, Form 1040) .00 Other gains or losses (submit a copy of federal Form 4797) .00 Taxable amount of IRA distributions. If received as a beneficiary, mark an X in the box .00 Taxable amount of pensions and annuities. If received as a beneficiary, mark an X in the box .00.00Rental real estate included in line 11 .00Farm income or loss (submit a copy of federal Schedule F, Form 1040) .00 Unemployment compensation .00Taxable amount of Social Security benefits (also enter on line 27) .00 Other income .00Add lines 1 through 11 and 13 through 16 .00Total federal adjustments to income .00Federal adjusted gross income (subtract line 18 from line 17) Recomputed federal adjusted gross income (see page 14, Line 19a worksheet) Interest income on state and local bonds and obligations .00 Public employee 414(h) retirement contributions from your wage and tax statements (see page 15) .00 New York's 529 college savings program distributions (see page 15) .00 Other (Form IT-225, line 9) .00Add lines 19a through 23 .00.00.00Taxable amount of Social Security benefits (from line 15) .00 Interest income on U.S. government bonds .00Pension and annuity income exclusion (see page 17) .00 New York's 529 college savings program deduction/earnings .00 Other (Form IT-225, line 18) .00Add lines 25 through 31 .00New York adjusted gross income (subtract line 32 from line 24) .00 Enter your standard deduction (table on page 19) or your itemized deduction (from Form IT-196) Mark an X in the appropriate box: .00Subtract line 34 from line 33 (if line 34 is more than line 33, leave blank) .00 Dependent exemptions (enter the number of dependents listed in item H; see page 19) Taxable income (subtract line 36 from line 35) .00 Whole dollars onlyYour Social Security number(see page 14)(see page 14)Taxable refunds, credits, or offsets of state and local income taxes (from line 4) Pensions of NYS and local governments and the federal government (see page 16).......NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM. 128 58 4975524325243252432524325243252432X 80004443244432PHONE NUMBER AVAILABLE(Form IT-360.1)Tax computation, credits, and other taxesNew York City and Yonkers taxes, credits, and surcharges, and MCTMT See instructions onpages 21 through 24 tocompute New York City andYonkers taxes, credits, andsurcharges, and MCTMT.IT-201 (2021) Page 3 of 438 3839 3940 4041 4142 4243 4344 4445 4546 4647 4747a 47a48 48494950 5051 5152 5253 53545454a54a54b 54b55 5556 5657 5758 5859 5960 6061 Total New York State, New York City, Yonkers, and sales or use taxes, MCTMT, and 61Name(s) as shown on page 1Taxable income (from line 37 on page 2) .00NYS tax on line 38 amount (see page 20) .00NYS household credit (page 20, table 1, 2, or 3) .00 Resident credit (see page 21) .00Other NYS nonrefundable credits (Form IT-201-ATT, line 7) .00 Add lines 40, 41, and 42 .00Subtract line 43 from line 39 (if line 43 is more than line 39, leave blank) .00 Net other NYS taxes (Form IT-201-ATT, line 30) .00 Total New York State taxes (add lines 44 and 45) .00 NYC taxable income (see page 21) .00NYC resident tax on line 47 amount (see page 21) .00 NYC household credit (page 21) .00Subtract line 48 from line 47a (if line 48 is more than line 47a, leave blank) .00Part-year NYC resident tax (Form IT-360.1) .00Other NYC taxes (Form IT-201-ATT, line 34) .00Add lines 49, 50, and 51 .00NYC nonrefundable credits (Form IT-201-ATT, line 10) .00 Subtract line 53 from line 52 (if line 53 is more than line 52, leave blank) .00MCTMT netearnings base .00MCTMT .00Yonkers resident income tax surcharge (see page 24) .00 Yonkers nonresident earnings tax (Form Y-203) .00Part-year Yonkers resident income tax surcharge .00 Total New York City and Yonkers taxes / surcharges and MCTMT (add lines 54 and 54b through 57) .00 Sales or use tax (see page 25; do not leave line 59 blank) .00 Voluntary contributions (Form IT-227, Part 2, line 1) .00 voluntary contributions (add lines 46, 58, 59, and 60) .00 Your Social Security number........NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM. AUDIE A DE LA CRUZ 128 58 49754443224172417241744432160016001600160016004017PHONE NUMBER AVAILABLEThird-partydesignee?(also complete F on page 1)(Form IT-195, line 4) (also submit Form IT-195)Print designee's name Designee's phone number Personal identification number (PIN)Email:Payments and refundable creditsYour refund, amount you owe, and account information Taxpayer(s) must sign hereSee instructions for where to mail your return.Page 4 of 4 IT-201 (2021)62 6263 6364 6465 6566 6667 6768 6869 6969a 69a70 7070a 70a71 7172 7273 73Do not send federal Form W-274 74with your return.75 7576 7677 7778 7878a 78a78b 78bpaperMark one refund choice: - or - check797980 See page 31 for payment options.808181 See page 36 for the proper82 82 assembly of your return.8383a - or - - or - - or -83b 83c84Yes NoPaid preparer must completeEnter amount from line 61 .00(see pages 26 through 29)Empire State child credit .00NYS/NYC child and dependent care credit .00NYS earned income credit (EIC) .00NYS noncustodial parent EIC .00Real property tax credit .00College tuition credit .00NYC school tax credit (fixed amount) .00NYC school tax credit (rate reduction amount) .00NYC earned income credit .00This line intentionally left blankOther refundable credits (Form IT-201-ATT, line 18) .00 If applicable, complete Form(s) IT-2 Total New York State tax withheld .00 and/or IT-1099-R and submit them with your return (see page 11).Total New York City tax withheld .00Total Yonkers tax withheld .00Total estimated tax payments and amount paid with Form IT-370 .00 Total payments (add lines 63 through 75) .00(see pages 30 through 32)Amount overpaid (if line 76 is more than line 62, subtract line 62 from line 76; see page 30) .00 Amount of line 77 available for refund (subtract line 79 from line 77) .00 TIP: Use this amount to check your refund status online. Amount of line 78 that you want to deposit into a NYS 529 account .00 Total refund after NYS 529 account deposit (subtract line 78a from line 78) .00 direct deposit to checking orsavings account (fill in line 83) Refund? Direct deposit is the easiest, fastest way to get yourAmount of line 77 that you want applied to your 2022 refund. estimated tax (see instructions) .00Amount 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. If you pay by check or money order you must complete Form IT-201-V and mail it with your return .00 Estimated tax penalty (include this amount in line 80 or reduce the overpayment on line 77; see page 31) .00 Other penalties and interest (see page 31) .00Account information for direct deposit or electronic funds withdrawal (see page 32). 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. 32) Account type: Personal checking Personal savings Business checking Business savings Routing number Account numberElectronic funds withdrawal (see page 32) Date Amount .00(see instructions)Your Social Security number(see instr.)Preparer's NYTPRIN NYTPRINexcl. codePreparer's signature Preparer's printed name 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) Date Date Daytime phone numberEmail: Email:.NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM. PHONE NUMBER AVAILABLE6395240216964256239239239XROSEMARY RODRIGUEZ PHONE NUMBER AVAILABLEX EMAIL AVAILABLE 1168512424627ROSEMARY RODRIGUEZLIBERTY TAX OFFICE 13786 P02011685 SECURITY GUARD425 E 149TH ST 84 3022768BRONX NY PHONE NUMBER AVAILABLE5 3540EMAIL AVAILABLE EMAIL AVAILABLEPHONE NUMBER AVAILABLELocality a Locality a Locality aLocality b Locality b Locality bLocality a Locality a Locality aLocality b Locality b Locality bBox 15aBox 15bBox 15aBox 15bBox c Employer's informationEmployer's nameBox a Employee's Social Security numberfor this W-2 Record Employer's addressBox b Employer identification number (EIN) City State ZIP code Country Box 1 Wages, tips, other compensation Box 12a Amount Code Box 14a Amount Description Box 8 Allocated tips Box 12b Amount Code Box 14b Amount Description Box 10 Dependent care benefits Box 12c Amount Code Box 14c Amount Description Box 11 Nonqualified plans Box 12d Amount Code Box 14d Amount Description Box 13 Statutory employee Retirement plan Third-party sick pay Box 16a NYS wages, tips, etc. Box 17a NYS income tax withheld NY StateBox 16b Other state wages, tips, etc. Box 17b Other state income tax withheld other stateBox 18 Local wages, tips, etc. Box 19 Local income tax withheld Box 20 Locality name Box c Employer's informationEmployer's nameBox a Employee's Social Security numberfor this W-2 Record Employer's addressBox b Employer identification number (EIN) City State ZIP code Country Box 1 Wages, tips, other compensation Box 12a Amount Code Box 14a Amount Description Box 8 Allocated tips Box 12b Amount Code Box 14b Amount Description Box 10 Dependent care benefits Box 12c Amount Code Box 14c Amount Description Box 11 Nonqualified plans Box 12d Amount Code Box 14d Amount Description Box 13 Statutory employee Retirement plan Third-party sick pay Box 16a NYS wages, tips, etc. Box 17a NYS income tax withheld NY StateBox 16b Other state wages, tips, etc. Box 17b Other state income tax withheld other stateBox 18 Local wages, tips, etc. Box 19 Local income tax withheld Box 20 Locality name New York State New York City YonkersDo not detach or separate the W-2 Records below. File Form IT-2 as an entire page with your return. See instructions. N YN YSummary of W-2 Statements IT-2W-2 Record 1W-2 Record 2Do not detach.Department of Taxation and Finance.00 .00 .00.00 .00 .00.00 .00 .00.00 .00 .00Corrected (W-2c)NY State information:.00 .00Other state information:.00 .00NYC and Yonkersinformation (see instr.):.00 .00.00 .00.00 .00 .00.00 .00 .00.00 .00 .00.00 .00 .00Corrected (W-2c)NY State information:.00 .00Other state information:.00 .00NYC and Yonkersinformation (see instr.):.00 .00.00 .00(number and street)(if not United States)(number and street)(if not United States)NO HANDWRITTEN ENTRIES ON THIS FORM.ACACIA NETWORK HOUSING INCPHONE NUMBER AVAILABLE E 175TH STREET26 0076866 BRONX NY 10457 000052432 31 C1069 D369 A A52432 240252432 1696 NYCPHONE NUMBER AVAILABLE2021New York New York City school tax credit (NYC residents only) WorksheetTable 1 - Full-year New York City residents:New York City school tax credit tableIf your income YourFiling status: credit* is:$ 63$ 125Table 2 - Part-year New York City residents:New York City school tax credit proration chartNew York City school tax credit worksheet(Keep for your records)(see below) is:Single, filing status (1), orMarried filing separatereturn, filing status (3), or $250,000 or lessHead of household,filing status (4)Married filing jointreturn, filing status (2)Qualifying widow(er) $250,000 or lessfiling status (5)* The statutory credit amounts have been rounded.If your income (see below) is $250,000 or less, and Your filing status is (1), (3) Your filing status is (2) or (4), your credit* is: or (5), your credit* is:1 $ 5 $ 102 10 213 16 314 21 425 26 526 31 637 36 738 42 839 47 9410 52 10411 57 11512 63 125* The statutory credit amounts have been rounded.* Income, for purposes of determining your New York City school tax credit, means your recomputed federal AGI from Form IT-201, line 19a, (or IT-203, line 19a, Federal amount column), minus distributions from an individual retirement account and an individual retirement annuity, from Form IT-201, line 9, if they were included in your recomputed federal AGI. 1. Full-year resident's credit from Table 1 above 1 2. Part-year resident's allowable credit from Table 2 above 2 3. Add lines 1 and 2. This is your New York City school tax credit. Enter here and on Form IT-201, line 69 3 Your social security numberNYWK_STC.LDName(s) as shown on returnResidentperiod(numberofmonths)AUDIE A DE LA CRUZ 128 58 497563.63.1024Calculation of NYC school tax credit(rate reduction amount) for married filing jointly and qualifying widow(er)Calculation of NYC school tax credit(rate reduction amount) for single andmarried filing separatelyCalculation of NYC school tax credit(rate reduction amount) for head of householdMust be a NYC Full or Part Year Resident.Taxable income must not be more than $500,0002021New York NYC School Tax Credit (Rate Reduction Amount) Worksheet: WorksheetIf city taxable income is:over but not over The credit is:If city taxable income is:over but not over The credit is:If city taxable income is:over but not over The credit is:112 If only one spouse was a full-year resident of NYC: 23 344$ 0 $ 21,600 .171% of taxable income21,600 500,000 $ 37 plus .228% of the excess over $21,600$ 0 $ 12,000 .171% of taxable income12,000 500,000 $ 21 plus .228% of the excess over $12,000$ 0 $ 14,400 .171% of taxable income14,400 500,000 $ 25 plus .228% of the excess over $14,400 NYC Taxable Income, from IT-201, Line 47 (NYC full year resident), or from IT-360.1 Line 47 (Part year NYC residents), or from NYC-1127, line 1 (NYC full year employment)NYC Taxable Income of the full-year NYC resident spouse Add lines 1 and 2NYC School Tax Credit, rate reduction amount, include on Form IT-201, Line 69a(Or Form IT-203, Line 60a), or NYC-1127, Schedule B, line A1 Your social security numberNYCSTCWK.LDName(s) as shown on returnAUDIE A DE LA CRUZ 128 58 497544432.44432.95.Department of Taxation and FinanceTaxpayer's name Spouse's name(from applicable line)Taxpayer's signature DateSpouse's signature DateERO's signature Print name DatePaid preparer's signature Print name DateTR-579-IT (9/21)1024New York State E-File Signature Authorization for Tax Year 2021 www.tax.ny.govFor Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, and NYC-210 PurposeGeneral instructionsPart A - Tax return informationPart B - Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, and NYC-210 Part C - Declaration of electronic return originator (ERO) and paid preparer Do not mail Form TR-579-IT to the Tax Department:Electronic return originator (ERO): Do not mail this form to the Tax Department. Keep it for your records. 1 1.2 2.3 3.4 4.5 5.6EROs must complete Part C prior to transmitting electronically Form TR-579-IT must be completed to authorize an ERO to filed income tax returns (Forms IT-201, IT-201-X, IT-203, IT-203-X, e-file a personal income tax return and to transmit bank account IT-214, and NYC-210). information for the electronic funds withdrawal.Both the paid preparer and the ERO are required to sign Part C. However, if an individual performing as both the paid preparer and Taxpayers must complete Part B before the ERO transmits the the ERO is only required to sign as the paid preparer. It is not taxpayers electronically filed Forms IT-201, Resident Income Tax necessary to include the ERO signature in this case. Note that an Return, IT-201-X, Amended Resident Income Tax Return, IT-203, alternative signature can be used as described in Publication 58, Nonresident and Part-Year Resident Income Tax Return, IT-203-X, Information for Income Tax Return Preparers, available on our Amended Nonresident and Part-Year Resident Income Tax Return, website. IT-214, Claim for Real Property Tax Credit, or NYC-210, Claim for New York City School Tax Credit. Note that an electronic This form is not required for electronically filed Form IT-370, signature can be used as described in TSB-M-20(1)C, (2)I, E-File Application for Automatic Six-Month Extension of Time to File Authorizations (TR-579 forms) for Taxpayers Using a Paid Preparer for Individuals. See Form TR-579.1-IT, New York State Taxpayer for Electronically Filed Tax Returns. Authorization for Electronic Funds Withdrawal for Tax Year 2021 For returns filed jointly, both spouses must complete and sign Form IT-370 and Tax Year 2022 Form IT-2105. Form TR-579-IT.Federal adjusted gross incomeRefundAmount you oweFinancial institution routing numberFinancial institution account numberAccount type: Personal checking Personal savings Business checking Business savings Under penalty of perjury, I declare that I have examined the IRS, together with this authorization, will serve as the electronic information on my 2021 New York State electronic personal income signature for the return and any authorized payment transaction. tax return, including any accompanying schedules, attachments, If I am paying my New York State personal income taxes due by and statements, and certify that my electronic return is true, electronic funds withdrawal, I certify that the account holder has correct, and complete. The ERO has my consent to send my 2021 authorized the New York State Tax Department and its designated New York State electronic return to New York State through the financial agents to initiate an electronic funds withdrawal from the Internal Revenue Service (IRS). In addition, by using a computer financial institution account indicated on my 2021 electronic return, system and software to prepare and transmit my form electronically, and authorized the financial institution to withdraw the amount from I consent to the disclosure to New York State of all information that account. As New York does not support International ACH pertaining to the transmission of my tax form electronically. I Transactions (IAT), I attest the source for these funds is within understand that by executing this Form TR-579-IT, I am authorizing the United States. I understand and agree that I may revoke this the ERO to sign and file this return on my behalf and agree that authorization for payment only by contacting the Tax Department no the EROs submission of my personal income tax return to the later than two (2) business days prior to the payment date. Under penalty of perjury, I declare that the information contained is identical to that contained in the paper copy of the return. If I am in this 2021 New York State electronic personal income tax the paid preparer, under penalty of perjury I declare that I have return is the information furnished to me by the taxpayer. If the examined this 2021 New York State electronic personal income taxpayer furnished me a completed paper 2021 New York State tax return, and, to the best of my knowledge and belief, the return return signed by a paid preparer, I declare that the information is true, correct, and complete. I have based this declaration on all contained in the taxpayers 2021 New York State electronic return information available to me. EROs must keep this form for three years and present it to the Tax Department upon request.(jointly filed return only)(jointly filed return only)AUDIE A DE LA CRUZFORM IT-20152432.239.04102023ROSEMARY RODRIGUEZ 04102023NYWK_AGI 2021For your records only.Adjusted Gross Income Split WorksheetFederal 1040 Income and AdjustmentsFederal 1040Schedule 1 - Additional IncomeSchedule 1 - Adjustments to IncomeAGISummaryName(s) as shown on state return Social Security Number Federal State1 12b 2b3b 3b4b 4b5b 5b6b 6b7 78 89 910 1011 11112a 2a3 34 4556 67 78 810 1011 11121213 1314 1415 15161617 1718 1819a 19a20 2021 2122 2223 2324 2426 26Col. A Col. B Col. A Col. BWages, salaries, tips, etc.Taxable interestOrdinary dividendsTaxable amount of IRA distributionsTaxable amount of Pensions and annuitiesTaxable amount of Social security benefitsCapital gain or (loss)Other income from Schedule 1Total income (Sum of Lines 1-8)Adjustments to income from Schedule 1Adjusted Gross Income (line 9 - line 10)Taxable refunds, credits, or offsetsof state and local income taxesAlimony receivedBusiness income or (loss)Other gains or (losses)Rental real estate, royalties, partnerships,S corporations, trusts, etc.Farm income or (loss)Unemployment compensationOther income.Total Additional Income (Sum of lines 1-8)Educator ExpensesCertain business expenses of reservists,performing artists, & fee-basis gov. officialsHealth savings account deductionMoving expensesDeductible part of self-employment taxSelf-employed SEP, SIMPLE, andqualified plansSelf-employed health insurance deductionPenalty on early withdrawal of savingsAlimony paidIRA deductionStudent loan interest deductionReservedArcher MSA DeductionOther Deductions (see STWK_ADJ)Total Adjustments to income (Sum of lines 11-24)NYWK_AGI.LD..FD/STAUDIE A DE LA CRUZ XXX-XX-XXXXTaxpayer Spouse Taxpayer Spouse52,432 52,43252,432 52,43252,432 52,4322021Three-year State Tax Return ComparisonNY-COMP[State] Income Tax Return 2019 2020 2021 Difference 2020-2021 Name(s) as shown on return Taxpayer ID NumberFiling StatusGross IncomeAdditionsSubtractionsExemptionsStandard DeductionItemized DeductionDeductionsTaxable IncomeActual State IncomeState Income TaxLocal TaxesUse TaxContributionsIncome Tax WithheldEstimates and Extension paymentsUnderpayment PenaltyOverpayment Applied to Next YearRefundBalance DueMarginal tax rateEffective tax rateNY-COMP.LD......AUDIE A DE LA CRUZ 128-58-4975S52,432 52,4328,000 8,00044,432 44,43244,432 44,4324,017 4 |
