Form
1040NR
U.S. Nonresident Alien Income Tax Return
Information about Form 1040NR and its separate instructions is at www.irs.gov/form1040nr.
Department of the Treasury
Internal Revenue Service
Your first name
beginning
M.I.
JOHN
For the year January 1–December 31, 2014, or other tax year
, and ending
Last name
SAMPLE
Identifying number (see instructions)
123-45-6789
Present home address (number, street, and apt. no., or rural route). If you have a P.O. box, see instructions.
Please print
or type
OMB No. 1545-0074
Check if:
123 ANYWHERE STREET
X
Individual
Estate or Trust
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
LONDON
A12 B23
Foreign country name
Foreign province/state/county
Foreign postal code
United Kingdom (England, Northern Ireland, Scotland, and Wales)
Filing
Status
1
2
X
3
Check only
one box.
Exemptions
Single resident of Canada or Mexico or single U.S. national
4
Other single nonresident alien
5
Other married nonresident alien
Married resident of Canada or Mexico or married U.S. national
6
Qualifying widow(er) with dependent child (see instructions)
If you checked box 3 or 4 above, enter the information below.
(i) Spouse's first name and initial
7a
b
X
(ii) Spouse's last name
on 7a and 7b
Spouse. Check box 7b only if you checked box 3 or 4 above and your spouse did not
1
have any U.S. gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter Dependents on "Ln 7c - Dependents" tab below.
(1) First name
Last name
d
Income
Effectively
Connected
With U.S.
Trade/
Business
Attach Form(s)
W-2, 1042-S,
SSA-1042S,
RRB-1042S,
and 8288-A
here. Also
attach Form(s)
1099-R if tax
was withheld.
Adjusted
Gross
Income
8
9a
b
10a
b
11
12
13
14
15
16a
17a
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
(2) Dependent's
identifying number
(3) Dependent's
relationship to you
(4)
if qualifying
child for child tax
credit (see instr.)
No. of children
on 7c who:
• lived with you
0
• did not live with you
Total number of exemptions claimed . . . . . . . . . . . . . . . . . . . . . . . .
due to divorce or
separation (see
instructions)
0
Dependents on 7c
not entered above
0
Add numbers
. on.lines
. above
. .
. . . . 1. . . .
. . . . . . . . . . . . Box
.. .. ..1
. . . of
. . . . .W-2
. . . . . . . .8. . . . . . . . . . .8,551
. .. .. .. .. .. .
Wages, salaries, tips, etc. Attach Form(s) W-2 . . . .
Taxable interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9a. . . . . . . . . . . .
Tax-exempt interest. Do not include on line 9a . . . . . . . . . . 9b
. . . . . . . . . . . . . . . . . . . . . .
Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10a
. .. . . . . . . . . . . .
Qualified dividends (see instructions) . . . . . . . . . . . . . . . . . . . . . . . .10b
...... . . . . . . . . . . . . . . . . . . .
Taxable refunds, credits, or offsets of state and local income taxes (see instructions) . . . . . .11. . . . . . . . . . .
Scholarship and fellowship grants. Attach Form(s) 1042-S or required statement (see instructions) . . . .12. . . . . . . . . . . .
Business income or (loss). Attach Schedule C or C-EZ (Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . .13
. .. .. .. .. .. . . . . . .
14
Capital gain or (loss). Attach Schedule D (Form 1040) if required. If not required, check here
Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. . . . . . . . . . . . . . .
IRA distributions . . . . . . . 16a
. . . . . . . . . . 16b
. . .Taxable
. . . amount
. . . (see
. .instructions)
. . . . . 16b
. . . . . . . . . . . .
Pensions and annuities . . . . .17a. . . . . . . . . . 17b
. . Taxable
. . . .amount
. . .(see
. instructions)
. . . . . .17b
. . . . . . . . . . . .
Rental real estate, royalties, partnerships, trusts, etc. Attach Schedule E (Form 1040) . . . . . 18
. . . . . . . . . . . .
Farm income or (loss). Attach Schedule F (Form 1040) . . . . . . . . . . . . . . . . . .19. . . . . . . . . . .
Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . 20
. . . . . . . . . . . .
21
Other income. List type and amount (see instructions)
Total income exempt by a treaty from page 5, Schedule OI, Item L (1)(e) . . . 22
. . . . . . . . . . . . . . . . . . . . . .
Combine the amounts in the far right column for lines 8 through 21. This is your total
effectively connected income . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
. . . . . . 8,551
. . . . . .
Educator expenses (see instructions) . . . . . . . . . . . . . . . 24. . . . . . . . . . . . . . . . . . . . . .
Health savings account deduction. Attach Form 8889 . . . . . . . . . 25. . . . . . . . . . . . . . . . . . . . . .
Moving expenses. Attach Form 3903 . . . . . . . . . . . . . . . 26. . . . . . . . . . . . . . . . . . . . .
Deductible part of self-employment tax. Attach Schedule SE (Form 1040) . . . 27
. . . . . . . . . . . . . . . . . . . . . .
Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . 28. . . . . . . . . . . . . . . . . . . . . .
Self-employed health insurance deduction (see instructions) . . . . . . 29
. . . . . . . . . . . . . . . . . . . . . .
Penalty on early withdrawal of savings . . . . . . . . . . . . . . 30
. . . . . . . . . . . . . . . . . . . . . .
Scholarship and fellowship grants excluded . . . . . . . . . . . . 31
. . . . . . . . . . . . . . . . . . . . . .
IRA deduction (see instructions) . . . . . . . . . . . . . . . . . 32
. . . . . . . . . . . . . . . . . . . . . .
Student loan interest deduction (see instructions) . . . . . . . . . . 33
. . . . . . . . . . . . . . . . . . . . . .
Domestic production activities deduction. Attach Form 8903 . . . . . . 34
. . . . . . . . . . . . . . . . . . . . . .
Add lines 24 through 34 . . . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..35.. .. .. .. .. .. .. .. .. .. .. ..
Subtract line 35 from line 23. This is your adjusted gross income . . . . . . . . . . . . . 36
. . . . . . 8,551
. . . . . .
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions.
HTA
(iii) Spouse's identifying number
Yourself. If someone can claim you as a dependent, do not check box 7a . . . . . . . . . Boxes
. . .checked
. . . . . . . . .
c Dependents: (see instructions)
If more
than four
dependents,
see instructions.
Married resident of South Korea
Form 1040NR (2014)
JOHN SAMPLE
123-45-6789
Page 2
Amount from line 36 (adjusted gross income) . . . . . . . . . . . . . . . . . . . . . . 37. . . . . 8,551
. . . . . .
Itemized deductions from page 3, Schedule A, line 15 . . Work
.. . . . .. . . . First
.. . . . .. .. . .. .. 38
. . . . . .
.. . . . .. . . on
. .. . . .F2106
. .. . . . . 8,210
Subtract line 38 from line 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39. . . . . . 341
. . . . .
Exemptions (see instructions) . . . . . . . . . . . . . . . . . . . . .Given
. . . . . . . 40
. . . . . . 3,950
. . . . . .
Taxable income. Subtract line 40 from line 39. If line 40 is more than line 39, enter -0- . . . . . 41
. . . . . . . .0 . . . .
a
b
42
Tax (see instructions). Check if any tax is from:
Form(s) 8814
Form 4972
Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . . . . . . . 43
. . . . . . . . . . .
Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . . . . . . . 44. . . . . . . . . . .
Add lines 42, 43 and 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45. . . . . . . . . . .
Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . .46. . . . . . . . . . . . . . . . . . . . .
47
Credit for child and dependent care expenses. Attach Form 2441
Retirement savings contributions credit. Attach Form 8880 . . . . . . 48
. . . . . . . . . . . . . . . . . . . . . .
Child tax credit. Attach Schedule 8812, if required . . . . . . . . . . 49
. . . . . . . . . . . . . . . . . . . . . .
Residential energy credits. Attach Form 5695 . . . . . . . . . . . . 50. . . . . . . . . . . . . . . . . . . . .
Form 1040NR (2014)
Tax and
Credits
Other
Taxes
Payments
Refund
Direct deposit?
See
instructions.
Amount
You Owe
Third Party
Designee
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59a
b
60
61
62
a
b
c
d
63
64
65
66
67
68
69
70
71
72
73 a
b
51
3800
8801
a
b
c
Add lines 46 through 51. These are your total credits . . . . . . . . . . . . . . . . . . .52. . . . . . . . . . .
Subtract line 52 from line 45. If line 52 is more than line 45, enter -0- . . . . . . . . . . . . .53. . . . . . . 0 . . . .
Tax on income not effectively connected with a U.S. trade or business from page 4, Schedule NEC, line 15 . . . . . 54. . . . . . . . . . .
Self-employment tax. Attach Schedule SE (Form 1040) . . . . . . . . . . . . . . . . . . 55
. . . . . . . . . . .
a
b
56
Unreported social security and Medicare tax from Form:
4137
8919
57
Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required
Transportation tax (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . 58. . . . . . . . . . .
Household employment taxes from Schedule H (Form 1040) . . . . . . . . . . . . . . . . 59a
. . . . . . . . . . .
First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . . . . . .59b
. . . . . . . . . . .
60
Taxes from: a
Form 8959 b
Instructions; enter code(s)
Add lines 53 through 60. This is your total tax . . . . . . . . . . . . . . . . . . . . . 61
. . . . . . . .0 . . . .
Federal income tax withheld from:
Form(s) W-2 and 1099 . . . . . . . . . . . . . . . . . . . . 62a
. . . . . . . . . . . . . . . . . . . . . .
Form(s) 8805 . . . . . . . . . . . . . . . . . . . . . . . . 62b
. . . . . . . . . . . . . . . . . . . . . .
Form(s) 8288-A . . . . . . . . . . . . . . . . . . . . . . . 62c
. . . . . . . . . . . . . . . . . . . . . .
Form(s) 1042-S . . . . . . . . . . . . . . . . . . . . . . . 62d
. . . . . . . . . . . . . . . . . . . . . .
2014 estimated tax payments and amount applied from 2013 return . . . . .63. . . . . . . . . . . . . . . . . . . . .
Additional child tax credit. Attach Schedule 8812 . . . . . . . . . . 64
. . . . . . . . . . . . . . . . . . . . . .
Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . 65
. . . . . . . . . . . . . . . . . . . . . .
Amount paid with request for extension to file (see instructions) . . . . . 66. . . . . . . . . . . . . . . . . . . . .
Excess social security and tier 1 RRTA tax withheld (see instructions) . . . . 67
. . . . . . . . . . . . . . . . . . . . . .
Credit for federal tax paid on fuels. Attach Form 4136 . . . . . . . . . 68. . . . . . . . . . . . . . . . . . . . .
69
a
Credits from Form:
2439 b
Reserved c
Reserved d
Credit for amount paid with Form 1040-C . . . . . . . . . . . . . 70
. . . . . . . . . . . . . . . . . . . . . .
Add lines 62a through 70. These are your total payments . . . . . . . . . . . . . . . . 71
. . . . . . . .0 . . . .
If line 71 is more than line 61, subtract line 61 from line 71. This is the amount you overpaid . . . . . . . 72
. . . . . . . . . . . .
73a
Amount of line 72 you want refunded to you. If Form 8888 is attached, check here
c Type:
Routing number
Checking
Savings
Other credits from Form:
d Account number
e If you want your refund check mailed to an address outside the United States not shown on page 1, enter it here.
74
75
76
74
Amount of line 72 you want applied to your 2015 estimated tax
Amount you owe. Subtract line 71 from line 61. For details on how to pay, see instructions . . . . . . .75. . . . . . . 0 . . . .
Estimated tax penalty (see instructions) . . . . . . . . . . . . . . 76
. . . . . . . . . . . . . . . . . . . . . .
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Phone
no.
Designee's name
Yes. Complete below.
Sign Here
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Keep a copy of
this return for
your records.
Your signature
Paid
Preparer
Use Only
Date
Make sure you SIGN & Date
Print/Type preparer's name
Preparer's signature
No
Personal identification
number (PIN)
Your occupation in the United States
If the IRS sent you an Identity
Protection PIN, enter it here
(see inst.)
INTERN
Date
Check
if
self-employed
Firm's name
Firm's EIN
Firm's address
Phone no.
PTIN
Form 1040NR (2014)
JOHN SAMPLE
Form 1040NR (2014)
123-45-6789
Page
Schedule A — Itemized Deductions (see instructions)
Taxes You
Paid
Gifts
to U.S.
Charities
Casualty and
Theft Losses
Job
Expenses
and Certain
Miscellaneous
Deductions
3
07
Box 17 of W-2
1
State and local income taxes . . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . . . 92
. . . . . . .
Caution: If you made a gift and received a benefit in
return, see instructions.
2
3
Gifts by cash or check. If you made any gift of $250 or
more, see instructions . . . . . . . . . . . . . . . . . 2. . . . . . . . . . . . . . . . . . . . . . . .
Other than by cash or check. If you made any gift of
$250 or more, see instructions. You must attach Form
8283 if the amount of your deduction is over $500 . . . . . . 3. . . . . . . . . . . . . . . . . . . . . . . .
4
Carryover from prior year . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . . . . . . . . .
5
Add lines 2 through 4 . . . . . . . . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .5. .. .. .. .. .. .. ..0 .. . . . . .
6
Casualty or theft loss(es). Attach Form 4684. See instructions . . . . . . . . . . . . 6. . . . . . . . . . . . .
7
Unreimbursed employee expenses—job travel, union dues,
job education, etc. You must attach Form 2106 or Form
2106-EZ if required. See instructions
2106EZ Filer Bus Exp
$
8,289
7
8,289
This is from
Form 2106EZ
8
Tax preparation fees . . . . . . . . . . . . . . . . . 8. . . . . . . . . . . . . . . . . . . . . . . .
9
Other expenses. See instructions for expenses to deduct
here. List type and amount
$
$
$
$
9
10
Add lines 7 through 9
. . . . . . . . . . . . . . . . .10. . . . . 8,289
. . . . . . . . . . . . . . . . . . .
11
Enter the amount from Form
1040NR, line 37 . . . . . . . . 11. . . . . . 8,551
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
Multiply line 11 by 2% (.02) . . . . . . . . . . . . . . . 12
. . . . . . 171
. . . . . . . . . . . . . . . . . .
13
14
Subtract line 12 from line 10. If line 12 is more than line 10, enter -0- . . . . . . . . .13. . . . . 8,118
. . . . . . . .
15
Is Form 1040NR, line 37, over the amount shown below for the filing status box you
checked on page 1 of Form 1040NR:
Box 1 of W-2
Other—see instructions for expenses to deduct here. List type and amount
Other
Miscellaneous
Deductions
14
Total
Itemized
Deductions
Move this #
to Line 38
Page 2
• $305,050 if you checked box 6,
• $254,200 if you checked box 1 or 2, or
• $152,525 if you checked box 3, 4, or 5?
X No. Your deduction is not limited. Add the amounts in the far right column for
lines 1 through 14. Also enter this amount on Form 1040NR, line 38.
Yes. Your deduction may be limited. See the Itemized Deductions Worksheet in
the instructions to figure the amount to enter here and on Form 1040NR, line 38.
15
8,210
Form 1040NR (2014)
JOHN SAMPLE
Form 1040NR (2014)
123-45-6789
Page
4
Schedule NEC—Tax on Income Not Effectively Connected With a U.S. Trade or Business (see instructions)
Enter amount of income under the appropriate rate of tax (see instructions)
Nature of income
1
a
b
2
a
b
c
3
4
5
6
7
8
9
10
a
b
11
12
13
14
15
(a) 10%
(b) 15%
(c) 30%
(d) Other (specify)
0%
Dividends paid by:
U.S. corporations . . . . . . . . . . . . . . . . . . . . . . . .1a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foreign corporations . . . . . . . . . . . . . . . . . . . . . . .1b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest:
Mortgage . . . . . . . . . . . . . . . . . . . . . . . . . . .2a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Paid by foreign corporations . . . . . . . . . . . . . . . . . . .2b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . .2c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Industrial royalties (patents, trademarks, etc.) . . . . . . . . . . . . .3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Motion picture or T.V. copyright royalties . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other royalties (copyrights, recording, publishing, etc.) . . . . . . . . . .5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Real property income and natural resources royalties . . . . . . . . . . 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pensions and annuities . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Social security benefits . . . . . . . . . . . . . . . . . . . . . 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Capital gain from line 18 below . . . . . . . . . . . . . . . . . . 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gambling—Residents of Canada only. Enter net income in column (c).
If zero or less, enter -0-.
Winnings
10c
Losses
0
Gambling winnings —Residents of countries other than Canada
Note. Losses not allowed . . . . . . . . . . . . . . . . . . . . . 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other (specify)
12
Add lines 1a through 12 in columns (a) through (d) . . . . . . . . . . . 13. . . . . . . 0. . . . . . . . 0. . . . . . . . 0. . . . . . . . 0. . . . . . .
Multiply line 13 by rate of tax at top of each column . . . . . . . . .14. . . . . . . 0. . . . . . . . 0. . . . . . . . 0. . . . . . . . 0. . . . . . .
Tax on income not effectively connected with a U.S. trade or business. Add columns (a) through (d) of line 14. Enter the total here and on
Form 1040NR, line 54 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. . .
0%
.
. 0
. 0.
0
Capital Gains and Losses From Sales or Exchanges of Property
Enter only the capital gains and
losses from property sales or
exchanges that are from sources
within the United States and
not effectively connected with
a U.S. business. Do not include
a gain or loss on disposing
of a U.S. real property interest;
report these gains and
losses on Schedule D
(Form 1040).
Report property sales or
exchanges that are effectively
connected with a U.S.
business on Schedule D (Form
1040), Form 4797, or both.
16
17
18
(a) Kind of property and description
(if necessary, attach statement of
descriptive details not shown below)
(b) Date
acquired
(mo., day, yr.)
(c) Date
sold
(mo., day, yr.)
(d) Sales price
(e) Cost or other
basis
(f) LOSS
If (e) is more
(g) GAIN
If (d) is more
than (d), subtract (d)
from (e)
than (e), subtract (e)
from (d)
Enter on Ln 16 - Input or Ln 16 - Detail tab
Add columns (f) and (g) of line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
. . ( . . . . . 0. . ) . . . . . . 0. . . . .
Capital gain. Combine columns (f) and (g) of line 17. Enter the net gain here and on line 9 above (if a loss, enter -0-)
18
0
Form 1040NR (2014)
Form 1040NR (2014)
JOHN SAMPLE
123-45-6789
Page
5
Schedule OI — Other Information (see instructions)
Answer all questions
A
Of what country or countries were you a citizen or national during the tax year? UNITED KINGDOM
B
In what country did you claim residence for tax purposes during the tax year?
C
Have you ever applied to be a green card holder (lawful permanent resident) of the United States? . . . . . . . . .Yes
. . .X . No
. . . . .
D
Were you ever:
1. A U.S. citizen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
. . . .X . No
. . . . .
UNITED KINGDOM
2. A green card holder (lawful permanent resident) of the United States? . . . . . . . . . . . . . . . . . . .Yes
. . .X . No
. . . . .
If you answer "Yes" to (1) or (2), see Pub. 519, chapter 4, for expatriation rules that apply to you.
E
If you had a visa on the last day of the tax year, enter your visa type. If you did not have a visa, enter your U.S.
immigration status on the last day of the tax year. J-1
F
Have you ever changed your visa type (nonimmigrant status) or U.S. immigration status? . . . . . . . . . . . . Yes
. . . X. . No
. . . . .
If you answered "Yes," indicate the date and nature of the change.
G
List all dates you entered and left the United States during 2014 (see instructions).
Note. If you are a resident of Canada or Mexico AND commute to work in the United States at frequent intervals,
check the box for Canada or Mexico and skip to item H . . . . . . . . . . . . . . Canada
. . . . . . Mexico
. . . . . . . . . . . . . . .
Date entered United States
mm/dd/yy
Date departed United States
mm/dd/yy
Date entered United States
mm/dd/yy
Date departed United States
mm/dd/yy
08/22/14
The numbers assume that you never left the US.
Adjust them if you did.
H
Give number of days (including vacation, nonworkdays, and partial days) you were present in the United States during:
2012
0
, 2013
130
, and 2014
234
.
I
Did you file a U.S. income tax return for any prior year? . . . . . . . . . . . . . . . . . . . . . . . .X . .Yes
. . . . No
. . . . . .
If "Yes," give the latest year and form number you filed . . . . . . 2013
. . . . . . 1040NR
. . . . . . . . . . . . . . . . . . . . . . . .
J
Are you filing a return for a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes
. . .X . No
. . . . .
If "Yes," did the trust have a U.S. or foreign owner under the grantor trust rules, make a distribution or loan to a
U.S. person, or receive a contribution from a U.S. person? . . . . . . . . . . . . . . . . . . . . . . . . Yes
. . . .X . No
. . . . .
K
Did you receive total compensation of $250,000 or more during the tax year? . . . . . . . . . . . . . . . . . Yes
. . . X. .No. . . . .
If "Yes," did you use an alternative method to determine the source of this compensation? . . . . . . . . . . . . Yes
. . . X. .No. . . . .
L
Income Exempt from Tax—If you are claiming exemption from income tax under a U.S. income tax treaty with a
foreign country, complete (1) and (2) below. See Pub. 901 for more information on tax treaties.
1. Enter the name of the country, the applicable tax treaty article, the number of months in prior years you claimed the treaty
benefit, and the amount of exempt income in the columns below. Attach Form 8833 if required (see instructions).
(b) Tax treaty
(c) Number of months
(d) Amount of exempt
(a) Country
claimed in prior tax years
income in current tax year
article
(e) Total. Enter this amount on Form 1040NR, line 22. Do not enter it on line 8 or line 12 . . . . . . . . . . . . . . . . . . . . 0 . . . .
2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above? . . . . . . . . . . . .Yes
. . . . No
. . . . .
Form 1040NR (2014)
Form
2106-EZ
Department of the Treasury
Internal Revenue Service (99)
OMB No. 1545-0074
Unreimbursed Employee Business Expenses
Attach to Form 1040 or Form 1040NR.
Information about Form 2106 and its separate instructions is available at www.irs.gov/form2106.
Your name
Occupation in which you incurred expenses
JOHN SAMPLE
Attachment
Sequence No.
129A
Social security number
INTERN
123-45-6789
You Can Use This Form Only if All of the Following Apply.
You are an employee deducting ordinary and necessary expenses attributable to your job. An ordinary expense is one that is
common and accepted in your field of trade, business, or profession. A necessary expense is one that is helpful and appropriate
for your business. An expense does not have to be required to be considered necessary.
You do not get reimbursed by your employer for any expenses (amounts your employer included in box 1 of your Form W-2
are not considered reimbursements for this purpose).
If you are claiming vehicle expense, you are using the standard mileage rate for 2014.
Caution: You can use the standard mileage rate for 2014 only if: (a) you owned the vehicle and used the standard mileage rate for the first year
you placed the vehicle in service, or (b) you leased the vehicle and used the standard mileage rate for the portion of the lease period after 1997.
Part I
Figure Your Expenses
Copy these numbers from the worksheet
1
Complete Part II. Multiply line 8a by 56¢ (.56). Enter the result here . . . . . . . . . . . . . . . .1 . . . . . . . . 0. . . . . .
2
Parking fees, tolls, and transportation, including train, bus, etc., that did not involve
overnight travel or commuting to and from work . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . . . 1,650
. . . . . . . .
3
Travel expense while away from home overnight, including lodging, airplane, car rental, etc.
Do not include meals and entertainment . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . . . 1,280
. . . . . . . .
4
Business expenses not included on lines 1 through 3. Do not include meals and
entertainment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . .
5
Meals and entertainment expenses: $
10,718 x 50% (.50). (Employees subject to
Department of Transportation (DOT) hours of service limits: Multiply meal expenses incurred
while away from home on business by 80% (.80) instead of 50%. For details, see instructions.) . . . . 5. . . . . . . 5,359
. . . . . . . .
6
Total expenses. Add lines 1 through 5. Enter here and on Schedule A (Form 1040), line 21
(or on Schedule A (Form 1040NR), line 7). (Armed Forces reservists, fee-basis state or local
government officials, qualified performing artists, and individuals with disabilities: See the
instructions for special rules on where to enter this amount.) . . . . . . . . . . . . . . . . . . .6 . . . . . . 8,289
. . . . . . . .
Part II
Information on Your Vehicle. Complete this part only if you are claiming vehicle expense on line 1.
7
When did you place your vehicle in service for business use? (month, day, year)
8
Of the total number of miles you drove your vehicle during 2014, enter the number of miles you used your vehicle for:
a Business
b Commuting (see instructions)
c Other
9
Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . . . . . . . . . Yes
. . . .No. . . . .
10
Do you (or your spouse) have another vehicle available for personal use? . . . . . . . . . . . . . . . . . . . Yes
. . . . No
. . . . .
11 a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
. . . . No
. . . . .
b If "Yes," is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
. . . . No
. . . . .
For Paperwork Reduction Act Notice, see your tax return instructions.
HTA
Form
2106-EZ
(2014)
Worksheet for Form 2106-EZ:
TRAINEE UNREIMBURSED BUSINESS EXPENSES
For August 2013 Intake, whose last day of placement was August 21, 2014:
In calendar year ending 12/31/2014, they were in the USA for 233 days.
→Local Transportation Expenses: $10/d x 5 work days x 33 weeks =
$1,650 (line 2)
→Meals & Incidentals Allowance: $46/d x 233 days = $10,718 (x50%*)= $5,359 (line 5)
$7,009 **
● You can also deduct your airfare expenses if needed ($1,280 is used in this sample)


*Only half of the meals & incidentals per diem is deductible.
**This amount goes on line 7 of Schedule A (page 3 of the 1040NR) and is
subject to 2% floor (line 12 of Schedule A) of the adjusted gross income (AGI) on
line 36

On line 1 of Schedule A, enter the NYS income tax withheld (box 17 on the W-2)

For 2014 tax year, the personal exemption (on line 40 of 1040NR) is $3,950
NOT TO BE FILED WITH YOUR TAX RETURNS
Numbers on this worksheet are for illustration only, and you need to make sure
you calculate the deductions’ period based on when you started employment
in the US minus any days outside the country.
IT-203
New York State Department of Taxation and Finance
Nonresident and Part-Year Resident
2014
Income Tax Return
New York State • New York City • Yonkers
14
For the year January 1, 2014, through December 31, 2014, or fiscal year beginning ............................................................
and ending ............................................................
For help completing your return, see the instructions, Form IT-203-I.
Your first name and middle initial
Your last name (for a joint return, enter spouse's name on line below)
JOHN
SAMPLE
Spouse's first name and middle initial
Spouse's last name
Your date of birth (mm-dd-yyyy)
123-45-6789
Spouse's date of birth (mm-dd-yyyy) Spouse's social security number
Mailing address (see instructions, page 13) (number and street or PO box)
Apartment number
123 ANYWHERE STREET
New York State county of residence
NR
City, village, or post office
State ZIP code
LONDON
Country (if not United States)
School district name
UNITED KINGDOM (ENGLAND,
NR NORTHERN IRELAND, SCOTLA
Taxpayer's permanent home address (see instr., pg 13) (no. and street or rural route)
State
Your social security number
ZIP code
Apartment no.
City, village, or post office
School district
code number
Taxpayer's date of death Spouse's date of death
Country (if not United States)
Decedent
information
A Filing
status
(mark an
X in one
box):
X
E New York City part-year residents only (see page 14)
Single
(1) Number of months you lived in NY City in 2014 ....................................
(2) Number of months your spouse lived
Married filing joint return
(enter both spouses' social security numbers above)
in NY City in 2014 ...................................................................................
Married filing separate return
F
(enter both spouses' social security numbers above)
Enter your 2-character special condition code
E4
if applicable (see page 14) .............................................................................
If applicable, also enter your second 2-character
special condition code ...................................................................................
Qualifying widow(er) with dependent child
G New York State part-year residents (see page 15)
B Did you itemize your deductions on your 2014
Enter the date you moved into
federal income tax return? .................................................................................................................................................................................................................
Yes X
No
or out of NYS (mm-dd-yyyy) .........................................................................
C Can you be claimed as a dependent on another
On the last day of the tax year (mark an X in one box):
taxpayer's federal return? ..................................................................................................................................................................................................................
Yes
No X
1) Lived in NYS ...........................................................................................
D1 Did you have a financial account located in a
2) Lived outside NYS; received income from
foreign country? (see pg. 14) ...............................................................................................................................................................................................................
Yes
No X
NYS sources during nonresident period .................................................
D2 Yonkers residents and Yonkers part-year residents only:
3) Lived outside NYS; received no income from
(1) Did you receive a property tax freeze credit?
NYS sources during nonresident period .................................................
(see page 14) ...............................................................................................................................................................................................................................
Yes
No
H New York State nonresidents (see page 15)
(2) If Yes, enter
Did you or your spouse maintain
the amount ................................................................................................................................................................................................................................
.00
living quarters in NYS in 2014? .....................................................................
Yes
No
(if Yes, complete Form IT-203-B)
D3 Did you receive a family tax relief credit?
(see page 14) .......................................................................................................................................................................................................................................
Yes
No X
Head of household (with qualifying person)
I
Dependent exemption information (see page 15)
First name and middle initial
Last name
Relationship
If more than 6 dependents, mark an X in the box.
For office use only
Social security number
Date of birth (mm-dd-yyyy)
Page 2 of 4
IT-203 (2014)
Enter your social security number
123-45-6789
Federal income and adjustments
1
2
3
4
5
6
7
8
9
(see page 16)
Federal amount
New York State amount
Whole dollars only
Whole dollars only
8,551 .00
8,551 .00
1
1
Wages, salaries, tips, etc. ............................................................................................................................................................................................
.00
.00
2
2
Taxable interest income ..............................................................................................................................................................................................
.00
.00
3
3
Ordinary dividends .......................................................................................................................................................................................................
Taxable refunds, credits, or offsets of state and local
.00
.00
4
4
income taxes (also enter on line 24) ..........................................................................................................................................................................
.00
.00
5
5
Alimony received .........................................................................................................................................................................................................
.00
.00
6
6
Business income or loss (submit a copy of federal Sch. C or C-EZ, Form 1040) ..........................................................................................................................................
.00
.00
7
7
Capital gain or loss (if required, submit a copy of federal Sch. D, Form 1040) ..............................................................................................................................................
.00
.00
8
8
Other gains or losses (submit a copy of federal Form 4797) ...........................................................................................................................................
.00
.00
9
9
Taxable amount of IRA distributions. Beneficiaries: mark X in box
.00 10
.00
10 Taxable amount of pensions/annuities. Beneficiaries: mark X in box
10
11 Rental real estate, royalties, partnerships, S corporations,
.00 11
.00
11
trusts, etc. (submit a copy of federal Schedule E, Form 1040) .......................................................................................................................................
12 Rental real estate included
.00
12
in line 11 (federal amount) ..........................................................................................................................................................................................
.00 13
.00
13 Farm income or loss (submit a copy of federal Sch. F, Form 1040) ..............................................................................................................................................
13
.00 14
.00
14 Unemployment compensation .....................................................................................................................................................................................
14
.00 15
.00
15 Taxable amount of social security benefits (also enter on line 26) .......................................................................................................................................
15
.00 16
.00
16 Other income (see page 22) Identify:
16
8,551 .00 17
8,551 .00
17 Add lines 1 through 11 and 13 through 16 ................................................................................................................................................................
17
18 Total federal adjustments to income (see page 22)
Identify:
.00 18
.00
18
8,551 .00 19
8,551 .00
19 Federal adjusted gross income (subtract line 18 from line 17) 19
New York additions
(see page 23)
20 Interest income on state and local bonds (but not those
.00 20
.00
20
of New York State or its localities) ................................................................................................................................................................................
.00 21
.00
21 Public employee 414(h) retirement contributions ........................................................................................................................................................
21
.00 22
.00
22 Other (Form IT-225, line 9) ...............................................................................................................................................................................................................
22
8,551 .00 23
8,551 .00
23 Add lines 19 through 22 ...............................................................................................................................................................................................
23
New York subtractions
(see page 24)
24 Taxable refunds, credits, or offsets of state and
.00 24
.00
24
local income taxes (from line 4) .................................................................................................................................................................................
25 Pensions of NYS and local governments and the
.00 25
.00
25
federal government (see page 24) .............................................................................................................................................................................
.00 26
.00
26 Taxable amount of social security benefits (from line 15) .............................................................................................................................................
26
.00 27
.00
27 Interest income on U.S. government bonds ................................................................................................................................................................
27
.00 28
.00
28 Pension and annuity income exclusion .......................................................................................................................................................................
28
.00 29
.00
29 Other (Form IT-225, line 18) ..........................................................................................................................................................................................
29
.00 30
.00
30 Add lines 24 through 29 ...............................................................................................................................................................................................
30
8,551 .00 31
8,551 .00
31 New York adjusted gross income (subtract line 30 from line 23) .........................................................................................................................................
31
8,551 .00
32 Enter the amount from line 31, Federal amount column ...........................................................................................................................................
32
You get to deduct the higher of your ietmiz ed
deductions from page 3 of 1040NR or
$7800 standard
Enter your standard deduction (table on page 26) or your itemized deduction (from Form IT-203-D).
Standard deduction or itemized deduction
33
(see page 26)
X Standard – or –
7,800 .00
Mark an X in the appropriate box: ............................................................................................................................................
Itemized 33
751 .00
34 Subtract line 33 from line 32 (if line 33 is more than line 32, leave blank) .......................................................................................................................
34
000 .00
35 Dependent exemptions (enter the number of dependents listed in Item I; see page 26) ...................................................................................................
35
751 .00
36 New York taxable income (subtract line 35 from line 34) ..............................................................................................................................................
36
Name(s) as shown on page 1
Enter your social security number
JOHN SAMPLE
123-45-6789
Tax computation, credits, and other taxes
37
38
39
40
41
42
43
IT-203 (2014)
Page 3 of 4
(see page 26)
751 .00
37
New York taxable income (from line 36 on page 2) .....................................................................................................................................................
38Use tax table 31 .00
New York State tax on line 37 amount (see page 27 and Tax computation on pages 60, 61, and 62) ..............................................................................
Given
45 .00
39
New York State household credit (page 27, table 1, 2, or 3) ..........................................................................................................................................
.00
40
Subtract line 39 from line 38 (if line 39 is more than line 38, leave blank) .......................................................................................................................
.00
41
New York State child and dependent care credit (see page 28) ...................................................................................................................................
.00
42
Subtract line 41 from line 40 (if line 41 is more than line 40, leave blank) .......................................................................................................................
.00
43
New York State earned income credit (see page 28) ....................................................................................................................................................
.00
44 Base tax (subtract line 43 from line 42; if line 43 is more than line 42, leave blank) ...........................................................................................................
44
45 Income
percentage
New York State amount from line 31
8,551 .00
(see page 28)
46
47
48
49
50
Federal amount from line 31
÷
8,551 .00
Round result to 4 decimal places
=
45
1.0000
.00
46
Allocated New York State tax (multiply line 44 by the decimal on line 45) .......................................................................................................................
.00
47
New York State nonrefundable credits (Form IT-203-ATT, line 8) ..................................................................................................................................
.00
48
Subtract line 47 from line 46 (if line 47 is more than line 46, leave blank) .......................................................................................................................
.00
49
Net other New York State taxes (Form IT-203-ATT, line 33) ..........................................................................................................................................
.00
50
Total New York State taxes (add lines 48 and 49) .......................................................................................................................................................
New York City and Yonkers taxes and credits
.00
51
Part-year New York City resident tax (Form IT-360.1) ................................................................................................................................................
See instructions on pages 28
Part-year resident nonrefundable New York City
and 29 to compute New York
.00
52
child and dependent care credit .............................................................................................................................................................................
City and Yonkers taxes,
.00
52a
52a Subtract line 52 from 51 ............................................................................................................................................................................................
credits, and surcharges.
.00
53 Yonkers nonresident earnings tax (Form Y-203) .........................................................................................................................................................
53
54 Part-year Yonkers resident income tax surcharge
.00
54
(Form IT-360.1) .........................................................................................................................................................................................................
.00
55 Total New York City and Yonkers taxes (add lines 52a, 53, and 54) .........................................................................................................................
55
51
52
56
.00
56
Sales or use tax (See the instructions on page 29. Do not leave line 56 blank.) ..........................................................................................................
Voluntary contributions
57a
57b
57c
57d
57e
57f
57g
57h
57i
57j
(see page 30)
.00
57a
Return a Gift to Wildlife .......................................................................................................................................................................................
.00
57b
Missing/Exploited Children Fund ........................................................................................................................................................................
.00
57c
Breast Cancer Research Fund ...........................................................................................................................................................................
.00
57d
Alzheimer's Fund ................................................................................................................................................................................................
.00
57e
Olympic Fund ($2 or $4) ......................................................................................................................................................................................
.00
57f
Prostate and Testicular Cancer Research and Education Fund ........................................................................................................................
.00
57g
9/11 Memorial .....................................................................................................................................................................................................
.00
57h
Volunteer Firefighting & EMS Recruitment Fund ................................................................................................................................................
.00
57i
Teen Health Education .......................................................................................................................................................................................
.00
57j
Veterans Remembrance .....................................................................................................................................................................................
.00
57 Total voluntary contributions (add lines 57a through 57j) ...........................................................................................................................................
57
58 Total New York State, New York City, and Yonkers taxes, sales or use tax,
.00
58
and voluntary contributions (add lines 50, 55, 56, and 57) ......................................................................................................................................
Page 4 of 4
Enter your social security number
IT-203 (2014)
123-45-6789
.00
59 Enter amount from line 58 ...........................................................................................................................................................................................
59
Payments and refundable credits
60
61
62
63
64
65
66
(see page 31)
.00
60
Part-year NYC school tax credit (also complete E on front; see page 31) ...........................................................................................................................................
.00
61
Other refundable credits (Form IT-203-ATT, line 17) .....................................................................................................................................................
Submit your wage and tax
92 .00
62
Total New York State tax withheld ..............................................................................................................................................................................
statements with your return
.00
63
Total New York City tax withheld ................................................................................................................................................................................
(see page 31).
.00
64
Total Yonkers tax withheld ..........................................................................................................................................................................................
.00
65
Total estimated tax payments/amount paid with Form IT-370 ......................................................................................................................................................
92 .00
66
Total payments and refundable credits (add lines 60 through 65) .............................................................................................................................
Your refund, amount you owe, and account information
(see pages 32 through 35)
92 .00
67 Amount overpaid (if line 66 is more than line 59, subtract line 59 from line 66) ..............................................................................................................
67
68 Amount of line 67 to be refunded
direct
debit
paper
X check ... 68
92 .00
Mark one refund choice:
deposit (fill in line 73) - or card - or -
See pages 32 and 33 for
information about your three
69 Amount of line 67 that you want applied
refund choices.
.00
69
to your 2015 estimated tax (see instructions) .............................................................................................................................................................
See page 33 for payment
70 Amount you owe (if line 66 is less than line 59, subtract line 66 from line 59). To pay by electronic
options.
and fill in lines 73 and 74. If you pay by check
funds withdrawal, mark an X in the box
.00
70
or money order you must complete Form IT-201-V and mail it with your return. .....................................................................................................
71 Estimated tax penalty (include this amount on line 70,
See page 36 for the proper
.00
71
or reduce the overpayment on line 67; see page 33) .....................................................................................................................................................
assembly of your return.
.00
72 Other penalties and interest (see page 33) ...................................................................................................................................................................
72
73 Account information for direct deposit or electronic funds withdrawal (see page 34).
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. 34)
73a Account type:
Personal checking - or -
73b Routing number
Personal savings - or -
73c
Account number
Business checking
Business savings
- or -
CHECK WITH YOUR BANK ABOUT THIS
.00
74 Electronic funds withdrawal (see page 34) ...................................................................................................................................................................
Date
Amount
Third-party
Print designee's name
designee? (see instr.)
Yes
No
E-mail:
Paid preparer must complete (see instr.)
Preparer's signature
Designee's phone number
Date
Taxpayer(s) must sign here
Preparer's NYTPRIN
Your signature
Firm's name (or yours, if self-employed)
Preparer's PTIN or SSN
Address
Employer identification number
NYTPRIN
excl. code
E-mail:
Personal identification
number (PIN)
SIGN HERE
Your occupation
INTERN
Spouse's signature and occupation (if joint return)
Date
Daytime phone number
|
E-mail:
See instructions for where to mail your return.
$0 - $5,999
Instructions for Form IT-203
Access our Web site at www.tax.ny.gov
51
2014 New York State Tax Table
If your New York adjusted gross income (line 32 of Form IT-203) is more than $104,600, you cannot use
these tables. See Tax computation — New York AGI of more than $104,600 beginning on page 60 to
compute your tax. Failure to follow these instructions may result in your having to pay interest and penalty if the
income tax you report on your return is less than the correct amount.
In this New York State tax
table, the taxable income
column is the amount from
Form IT-203, line 37.
If line 37
(taxable
income) is –
At
least
But
less
than
Example: Mr. and Mrs. Jones are filing a
joint return. Their taxable income on line 37
of Form IT-203 is $38,275. First, they find the
38,250 - 38,300 income line. Next, they find
the column for Married filing jointly and read
down the column. The amount shown where
the income line and filing status column meet is
$1,826. This is the tax amount they must write
on line 38 of Form IT-203.
If line 37
(taxable
income) is –
And you are –
Single
or
Married
filing
separately
Married
filing
jointly *
Head
of a
household
At
least
But
less
than
Married
filing
jointly *
At
least
But
less
than
38,200
38,250
38,300
38,350
38,250
38,300
38,350
38,400
Head
of a
household
And you are –
Single
or
Married
filing
separately
Married
filing
jointly *
Head
of a
household
Your New York State tax is:
If line 37
(taxable
income) is –
And you are –
Single
or
Married
filing
separately
If line 37
(taxable
income) is –
At
least
But
less
than
2,136
2,139
2,142
2,145
1,823
1,826
1,829
1,832
1,969
1,973
1,976
1,979
And you are –
Single
or
Married
filing
separately
Married
filing
jointly *
Head
of a
household
Your New York State tax is:
$0
13
25
50
100
150
200
250
300
350
400
450
500
550
600
650
700
750
800
850
900
950
$13
25
50
100
150
200
250
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1,000
1,000
1,000
1,050
1,100
1,150
1,200
1,250
1,300
1,350
1,400
1,450
1,500
1,550
1,600
1,650
1,700
1,750
1,800
1,850
1,900
1,950
1,050
1,100
1,150
1,200
1,250
1,300
1,350
1,400
1,450
1,500
1,550
1,600
1,650
1,700
1,750
1,800
1,850
1,900
1,950
2,000
$0
1
2
3
5
7
9
11
13
15
17
19
21
23
25
27
29
31
33
35
37
39
$0
1
2
3
5
7
9
11
13
15
17
19
21
23
25
27
29
31
33
35
37
39
$0
1
2
3
5
7
9
11
13
15
17
19
21
23
25
27
29
31
33
35
37
39
Your New York State tax is:
41
43
45
47
49
51
53
55
57
59
61
63
65
67
69
71
73
75
77
79
41
43
45
47
49
51
53
55
57
59
61
63
65
67
69
71
73
75
77
79
41
43
45
47
49
51
53
55
57
59
61
63
65
67
69
71
73
75
77
79
2,000
2,000
2,050
2,100
2,150
2,200
2,250
2,300
2,350
2,400
2,450
2,500
2,550
2,600
2,650
2,700
2,750
2,800
2,850
2,900
2,950
2,050
2,100
2,150
2,200
2,250
2,300
2,350
2,400
2,450
2,500
2,550
2,600
2,650
2,700
2,750
2,800
2,850
2,900
2,950
3,000
3,000
3,000
3,050
3,100
3,150
3,200
3,250
3,300
3,350
3,400
3,450
3,500
3,550
3,600
3,650
3,700
3,750
3,800
3,850
3,900
3,950
* This column must also be used by a qualifying widow(er)
3,050
3,100
3,150
3,200
3,250
3,300
3,350
3,400
3,450
3,500
3,550
3,600
3,650
3,700
3,750
3,800
3,850
3,900
3,950
4,000
Your New York State tax is:
81
83
85
87
89
91
93
95
97
99
101
103
105
107
109
111
113
115
117
119
81
83
85
87
89
91
93
95
97
99
101
103
105
107
109
111
113
115
117
119
81
83
85
87
89
91
93
95
97
99
101
103
105
107
109
111
113
115
117
119
Your New York State tax is:
121
123
125
127
129
131
133
135
137
139
141
143
145
147
149
151
153
155
157
159
121
123
125
127
129
131
133
135
137
139
141
143
145
147
149
151
153
155
157
159
121
123
125
127
129
131
133
135
137
139
141
143
145
147
149
151
153
155
157
159
4,000
4,000
4,050
4,100
4,150
4,200
4,250
4,300
4,350
4,400
4,450
4,500
4,550
4,600
4,650
4,700
4,750
4,800
4,850
4,900
4,950
4,050
4,100
4,150
4,200
4,250
4,300
4,350
4,400
4,450
4,500
4,550
4,600
4,650
4,700
4,750
4,800
4,850
4,900
4,950
5,000
5,000
5,000
5,050
5,100
5,150
5,200
5,250
5,300
5,350
5,400
5,450
5,500
5,550
5,600
5,650
5,700
5,750
5,800
5,850
5,900
5,950
5,050
5,100
5,150
5,200
5,250
5,300
5,350
5,400
5,450
5,500
5,550
5,600
5,650
5,700
5,750
5,800
5,850
5,900
5,950
6,000
Your New York State tax is:
161
163
165
167
169
171
173
175
177
179
181
183
185
187
189
191
193
195
197
199
161
163
165
167
169
171
173
175
177
179
181
183
185
187
189
191
193
195
197
199
161
163
165
167
169
171
173
175
177
179
181
183
185
187
189
191
193
195
197
199
Your New York State tax is:
201
203
205
207
209
211
213
215
217
219
221
223
225
227
229
231
233
235
237
239
201
203
205
207
209
211
213
215
217
219
221
223
225
227
229
231
233
235
237
239
201
203
205
207
209
211
213
215
217
219
221
223
225
227
229
231
233
235
237
239