NY General, Residency, Amended Return [5] [6] Residency Status = Part year resident City of Yonkers...[16]

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1 NYGen NY General, Residency, Amended Return Estate/trust name (Force) [] Fiduciary name and title (Force) [] Address (Electronically filed returns only)(if different from federal) Line (Primary address information) [] Line (Secondary address information).....[] Authorize discussion with taxing agency (If different from federal) ( = Yes, = No) [] Designee s name () [6] Designee s phone number [] Personal identification number [] Designee's address [] Calculate Form IT--A due to a change of residency status (Irrevocable trust) [] Use special allocations for beneficiary amounts [] General footnote ()[ ] Page # NY General footnote Schedule K- Equivalent only/grantor Report ()[ ] Residency Status Months of residency in: New York State (Default based on postal code) [] = Full year resident City of New York [] - = Part year resident City of Yonkers [6] Blank = Full year nonresident Resident Trust Nontaxable Certification All trustees domiciled outside New York State Entire corpus of trust located outside New York State All income and gains from sources outside New York State Incomplete gift non-grantor trust ( = Yes, = No) Accumulation distribution to resident beneficiary ( = Yes, = No) Amended Return Information [] [] [] [] [] Amended return (If different from federal)( = Yes, = No) [] Amended return explanation ()[ ] Qualifying special condition code ( = Protective claim, = Net operating loss (NOL)) [] Paid with original return [] Overpayment applid [6] Refund shown on original return [] Underpayment penalty on original return [] NYCO New York Carryovers Capital Loss Carryovers Short-term Long-term FNYGEN 0 /0/ FIDUCIARY [] [] -A, Schedule IRC Section 66 Undistributed Amounts Interest income [] Dividends [] [] [6] Other income [6] [] Business income [] [] Rental real estate [] [] Other rental income [] [] Short-term capital gains/losses [] [] Long-term capital gains/losses [] [] US income [] Tax-exempt income [] [] Total [] [] ESBT New York ExacTax, Inc. NY

2 NYEst New York Estimates Overpayment NYEst () NYA Application of current year overpayment Amount for code or Form IT-6 Next year declaration Amounts for code Amounts for code or : st payment nd payment 6 rd payment th payment Next year's payments made: st payment nd payment rd payment th payment Amounts for code 6: Taxable income Taxes Credits Withholding 6 Number of vouchers desired next year, if other than four Factor for rounding estimates Treat th quarter estimate as due / New York State 6 City of New York 0 6 City of Yonkers 0

3 NYPay New York Payment, Extension, Lump-Sum Distribution Modifications, Taxes, Payments, Credits New York State City of New York Paid with extension, for Form IT- Nonrefundable state credits Accumulation distribution credit Sales or use tax Refundable credits Tax withheld, not entered elsewhere Extension NYPay () City of Yonkers All NYB Extended due date Balance due on extension (Force) New York State City of New York City of Yonkers Lump-Sum Distribution Lump-sum from New York State, federal or political subdivisions thereof Multiple recipient percentage New York State City of New York 6

4 NYPen New York Penalties Penalties and Interest NYPen () NYC Date filed, if other than due date of return Force regular method calculation Prior year: Tax Adjusted gross income Waiver requested: Explanation Amount, if not 0% New York State, City, and Yonkers withholding as actually withheld (Force): st quarter nd quarter rd quarter th quarter Suppress on Form IT-: Underpayment of estimated tax penalty Late interest Failure to file penalty Failure to pay penalty 6 Annualized Income Installment Method Months Months New York State: Adjusted gross income (Force) Income percentage (Force) 6 6 Other nonrefundable credits (Force) Other taxes (Force) Other refundable credits (Force) City of New York: Adjusted gross income (Force) 0 NYC tax on cap gain, lump sum (Force) Tax on ordinary portion, lump sum (Force) Other New York City credits (Force) City of Yonkers: Nonresident earnings tax (Force) 0 Months 6 0 Months 6

5 NYBank New York Direct Deposit and Electronic Funds Withdrawal Fiduciary Income Tax, Form IT- NYBank () NY Suppress direct deposit of refund Electronic funds withdrawal (EFW) for balance due return: Requested payment date, original (Mandatory if using the EFW method) Amount of tax payment (Force) Requested payment date, amended (Mandatory if using the EFW method) Amount of tax payment (Force) Electronic funds withdrawal for balance due extension: Requested payment date (Mandatory if using the EFW method) 6 Fiduciary Estimates, Form IT-6 Available only when filing the tax return electronically Electronic funds withdrawal requested payment date(s) for estimated tax (Mandatory if using the EFW method): Due Date Other All st nd rd th Account Information Mandatory if using direct deposit or the electronic funds withdrawal method Routing transit number Name of financial institution Account number Type of account ( = Checking, = Savings) Non-US financial institution Business / personal account indicator for automatic withdrawal ( = Business, = Personal) 6

6 NYIncome New York Source Net Income NYIncome () NY Net Income Use fields to override calculated amounts as shown on New York Allocation of Expenses by Income Type Worksheet Interest Dividends Other income: Business Rent / royalty Partnership Estate / trust Farm Ordinary gain Other Business income: Business Partnership / S corporation Estate / trust Farm Rental real estate income: Rent / royalty Partnership / S corporation Estate / trust Other rental income: Rent / royalty Partnership / S corporation Estate / trust Short-term capital gain or (loss) Long-term capital gain or (loss) 6 6 Force

7 NYAdj NY Modifications and Fiduciary Adjustment Overflow # Principal Modifications [ ] Principal modifications NY # Code* Description () New York State Total NYS ESBT/QSST New York City Total NYC ESBT/QSST Yonkers IT- Schedule B ESBT/QSST (Force) Total Passthrough state tax adjustments [] [] Interest on state and local bonds other than New York (Force) [] Expense attributable to obligations of other states (Force) [6] [] [] [ ] Other additions (Code: see instructions) # Code Description () Amount [ ] Other subtractions (Code: see instructions) # Code Description () Amount IT- Schedule C If inter vivos trust Name (6) [] Street address (6) [] City, State and Zip code (6) [] [] [] If revocable trust, change of residence date....[] (mm/dd/yy) If estate, enter last address of decedent Street address (6) [6] City, State and Zip code (6) [] [] [] Convicted of bribery involving public servants and related offenses (NYS Penal Law Article 0 or 6, or section.)..... [] Required to report nonqualified deferred compensation (P.L. -, Div. C, section 0(d)()) [] * Codes: A = Sale/disposition adjustment (NY adj basis > Fed basis) B = Income earned before 60 and reported on prior NY return C = Wages for which a federal credit was claimed but not expense D = Gain from sale of new business investment adjustment E = Percentage depletion on mines, oil & gas wells, etc. F = Special additional mortgage recording tax deducted G = Special additional mortgage recording tax basis adjustment H = Gain/loss on disposal of decendent's property adjustment I = Special depreciation J = New business investment: deferral recognition K = Deductions attributable to safe harbor leases L = Safe harbor leases: election for qualified lease property M = Acrs - Depreciation adjustment N = Acrs - Year of disposition adjustment O = Gain on property transferred to trust at less than FMV P = Refund of the QEZE credit for real property taxes Q = NOL deduction limitation FNYADJ 0 0/0/ FIDUCIARY ExacTax, Inc. NY

8 NY Depr Depreciation Overflow # NY6 Beneficiary Deductions Other Business / Rental Depreciation (Force) [] [] Depletion (Force) [] [] Amortization (Force) [] [6] Depreciation Adjustments Form IT- [ ]Depreciation information: # Description () Class Date in Service Cost/Basis Method Life Accum NY Depreciation Federal Depreciation NY Deprec Postal Code Schedule # Activity # # Description () Class Date in Service Cost/Basis Method Life Accum NY Federal Depreciation Depreciation NY Deprec Postal Code Schedule # Activity # [ ] Disposition adjustments # Description () Class Date in Service Date of Disposition Method NY Deprec ACRS Deprec Postal Activity # Code Schedule # Form IT- [ ] Computation of allowable NY depreciation # Description () Class Date in Service Cost/Basis Prior YR New York Depreciation Federal Depreciation Method Life Allowable New York Deprec Schedule Convt Activity # Number # Description () Class Date in Service Cost/Basis Prior YR New York Depreciation Federal Depreciation Method Life Allowable New York Deprec Schedule Convt Activity # Number [ ] Disposition adjustments Federal # Description New York () Class Date in Service Depreciation Depreciation Adjustment Adjustment Method FNYOTH 0 /0/ FIDUCIARY ExacTax, Inc. NY6

9 NYCr New York Credit for Other State Income Taxes Paid Postal code of other taxing authority Income and Adjustments NYCr () NYA Wages, salaries, tips, etc. Taxable interest income Ordinary dividends Taxable refunds Business income or (loss) Capital gain or (loss) Other gains or (losses) IRA distributions Pensions and annuities Rental real estate, royalties, partnerships, etc. Farm income or (loss) Other income Federal adjustments to income Capital gain portion of lump-sum distributions 6 6 Other Taxing Authority Return Information Income tax paid to other state or government Total tax withheld and/or estimated taxes paid Refund Balance due Taxes Paid to a Province of Canada Part : Canadian province taxes paid Reduction in foreign taxes paid to Canadian province Amount carried back and claimed as a credit Carryover of taxes paid for prior years Current year foreign tax credit for taxes paid Prior year(s) resident credit claimed for taxes paid Part : Provincial tax Total tax payable Prepayments Refund Balance due 0 Canada 6 Quebec

10 NYCr- New York Credit Against Tax on Lump-Sum Distributions Postal code of other taxing authority Other Taxing Authority Return Information NYCr- () NYB Tax on lump-sum distributions If lump-sum distributions are NOT subject to separate tax: Federal Form, line income subject to tax Total income subject to tax on lump-sum distribution Total tax payable Form IT-0 line subject to tax 6 Taxes on Lump-Sum Paid to a Province of Canada Canadian province tax on lump-sum distributions (in U.S. dollars) If lump-sum distributions are NOT subject to separate tax: Form, line income subject to Canadian tax Total income subject to tax on lump-sum Total tax payable Foreign tax paid pertaining to tax on lump-sum Form IT-0 line subject to tax

11 NYCr- New York Other Credits NYCr- () NYC Form IT- - Pass-through Information Partnership: Name Year end Employer identification number Form NYC-, line amount Form NYC-, line amount Percentage of total distributive shares, Form NYC-, Schedule C, column Estate / Trust: Name Employer identification number Beneficiary share of New York City unincorporated business taxes imposed Form NYC--EIN, line amount Form IT-, Worksheet A, line share of unincorporated business tax (Force) 6 Other Addbacks IT- Line b investment credit IT- Farmers' school tax credit on early dispositions IT- NYC general corporation tax paid credit IT-60 EZ capital tax credit recapture IT-60 EZ investment credit on early dispositions IT-60 EZ investment (financial services industry) on early dispositions IT-606 QEZE credit for real property taxes IT-60 Recapture of excelsior jobs program tax credit IT-6 Brownfield redevelopment tax credit recapture (Prior to June, 0) IT-6. Brownfield redevelopment tax credit recapture (On or after June, 0) IT-6. Brownfield redevelopment tax credit recapture (On or after July, ) IT-6 Remediated Brownfield real property tax credit recapture IT-6 Recapture of environmental remediation insurance credit IT-6 Alternative fuels and electric vehicle recharging property credit recapture IT-6 Manufacturer's real property tax credit recapture IT-6 Recapture of START-UP NY tax benefits 6 6

12 NYA NY IT--A Schedules and Overflow # NY New York State City of New York Income: (Force) Interest [] Dividends [] Short - term capital gain/loss [] Long - term capital gain/loss [] Ordinary gain/loss [] Deductions: Interest []. [6] Taxes [] [] Fiduciary fees [] [] Attorney, accountant fees [] [] Other deductions not subject to % floor [] [] Miscellaneous deductions subject to % floor [6] [] Short - term gain allocated to beneficiaries [] Long - term gain allocated to beneficiaries [] Income distribution deduction [] Estate tax deduction [] Exemption [] [6] Calculation of distributable net income: Adjusted tax - exempt interest [] [] Share of NY fiduciary adjustment [] ESBT / QSST: Federal taxable income of fiduciary [] Share of NY fiduciary adjustment [0] IT--A Schedule 6 [] [] [] [] [] [] [] [6] [] [] [] [0] City of Yonkers IT--A Schedule NewYorkState Use federal amounts [] [0] Paid for charitable purposes from current year income [] [] Permanently set aside from current year income [] [] Allocable tax - exempt income [] [] Long - term capital gains included in current year income [] [] LTCG paid and permanently set aside for charitable purposes [6] [] Long - term capital gains subject to section exclusion [] [6] Short - term capital gains included in current year income [] [] STCG paid and permanently set aside for charitable purposes [] [] CityofNewYork [ ] Capital gains and loss # Description (6) Date Acquired Date Sold Sales Price Cost/Basis [60] Postal Code Adj. to Gain/Loss FNYA 0 0/0/ FIDUCIARY ExacTax, Inc. NY

13 NYC NY Business Profit or Loss Overflow # Activity unit number [] Employer identification number [] Business activity () [] Name () [] State postal code [] Address () [6] City (), state and zip code.....[] [] [] Material participation ( = Yes, = No) [] City code (nyc = City of New York, YON = City of Yonkers) [] Passive activity code ( = Other passive activity, = No limitation applies (Default)) [] Net self - employment income/loss [] Form Y-6 Subtractions NY [ ] Earnings paid/permanently set aside for charitable purposes # Description () Amount [ ] Earnings distributable to city residents # Description () Amount Allocation of Net Earnings [ 6] Addresses for business carried on both in and out of the state/city # Street () City () State NYC/YON Description () Income can be determined from books [] Everywhere New York State City of New York City of Yonkers Statutory formula factors: Real property owned [] [] [0] [6] Real property rented [] [] [] [] Tangible personal property owned [] [6] [] [] Tangible personal property rented [] [] [] [] Wages and salaries [] [] [] [0] Gross sales [] [] [] [] Allocation percentage (Force) (xx.xx)[] [] [] Amount to be allocated (Force) [] [6] [] FNYC 0 0/0/ FIDUCIARY ExacTax, Inc. NY

14 NYF EIN Activity Name New York Farm Profit or Loss Unit State NYF () NY General Information Material participation ( = Yes, = No) City code (NYC = City of New York, YON = City of Yonkers) Passive activity code ( = Other passive activity, = No limitation applies) Net self-employment income or (loss) 6 Form Y-6 Subtractions Earnings paid / permanently set aside for charitable purposes Earnings distributable to city residents Allocation of Net Earnings Addresses for businesses carried on both in and out of the state / city Income can be determined from books Statutory formula factors: Real property owned Real property rented (x ) Tangible pers prop owned Tangible pers prop rented Wages and salaries Gross sales 6 Everywhere New York State 6 0 City of New York 6 City of Yonkers Allocation percentage (Force) Amount to be allocated (Force) 0

15 NYK NY Forms 6 and S Schedule K- General Information Overflow # Activity unit number [] Employer identification number..[] Name () [] State postal code [] Address (6) [] City (), state and zip code.....[6] [] [] Type ( = Partnership (Default), = S Corporation, = Foreign Partnership, = PTP, = Farm Partnership) [] City code (nyc = City of New York, YON = City of Yonkers) [] Passive activity code.... ( = Other passive activity, (Default), = Rental RE with active participation, = No limitation applies) [] Income NY Business income [] Rental real estate [] Other rental income [] Other income/loss [] Net self-employment income/loss (Form Y-6 ) [6] Form Y-6 Subtractions [ ] Earnings paid/permanently set aside for charitable purposes # Description () Amount [ ] Earnings distributable to city residents # Description () Amount Allocation of Net Earnings [ ] Addresses for business carried on both in and out of the state/city # Street () City () State NYC/YON Description () Income can be determined from books [] Everywhere New York State City of New York City of Yonkers Statutory formula factors: Real property owned [] [] [] [] Real property rented [] [] [] [0] Tangible personal property owned [] [] [] [] Tangible personal property rented [] [0] [6] [] Wages and salaries [] [] [] [] Gross sales [6] [] [] [] Allocation percentage (Force) (xx.xx) [] [6] [] Amount to be allocated - Business/Rental (Force) [] [] [0] Amount to be allocated - Other income (Force) [] [] [] FNYK 0 /0/ FIDUCIARY ExacTax, Inc. NY

16 NYSale Description New York Sale of Business Property General Information Form Unit NYSale () State NYA Treatment code / description 6 Section 0 property Disposition due to casualty or theft (Part III assets only; used to determine gains for Form 6) Date acquired Date sold Gross sales price or insurance proceeds received Cost or other basis Commissions and other expenses of sale Depreciation allowed or allowable Sale Information Gain from Disposition of Property 0: Additional depreciation after 0: Applicable percentage, if other than 0 0: Additional depreciation after 6 : Soil, water and land clearing expenses : Applicable percentage, if other than 0 : Intangible drilling and development costs : Applicable payments excluded from income under section 6 Installment Sales 6 Mortgage and other debts the buyer assumed Total current year payments received Related party name Property sold was a marketable security ( = Yes, = No) Date of second sale Special condition if applicable ( = Sale or exchange, = Involuntary conversion, = Death of seller, = No tax avoidance) Selling price of property sold by related party 6

17 NYKSale Description New York Section Pass-Through Sale General Information Form NYKSale () Unit State NYB Treatment code / description 6 Delete on next year's proforma Disposition due to casualty / theft (Part III assets only: used to determine gains to carry to Form 6) Sale to related party Sale Information Date acquired Date sold Gross sales price or insurance proceeds received Cost or other basis Commissions and other expenses of sale Depreciation allowed or allowable excluding section Total section expense deduction 6 Form 6 - Current Year Installment Sales Sale is a prior year installment Prior year gross profit percentage (Force) Mortgage and other debts the buyer assumed Total current year payments received Prior year payments received Income recapture from Form Beginning of year, remaining gross profit Form 6 - Related Party Installment Sale Information Related party: Name Address City, state, zip code Identification number Property sold was a marketable security ( = Yes, = No) Date of second sale Special condition if applicable ( = Sale or exchange, = Involuntary conversion, = Death of seller, = No tax avoidance) Explanation if no tax avoidance purpose 6 0 Selling price of property sold by related party

18 NYPOA New York Power of Attorney General Information NYPOA () NY Person signing if not taxpayer named Title of person signing Representative Information Only the first two representatives will be used on Form POA- Representative information Alternate representative to receive notices, etc Representatives authorized to do the following: Sign tax returns (including refund/credit applications) Delegate authority to another individual Tax type, years, periods Offer in compromise Conciliation conference or Tax Appeals hearing Limits of authority granted by this POA Revoke prior POAs Authority Granted Data entry in the "Tax type" statement is mandatory for Form POA- to print 6

19 NYR EIN Name New York Retirement Income NYR () State NY Payer's: Address City, state, zip code Income type Account number Does not qualify for exclusion Form -R Information 6 Box Gross distribution Box Capital gain (included in box a) Box st year of desig. Roth contrib. Box a Taxable amount Box b Taxable amount not determined Total distribution Box Distribution code(s) 6 Box a Percentage of distribution Box b Employee contributions Box Amount allocable to IRR Corrected (-R) Box NY State Box NY State Box Locality a Locality b Box 6 Locality a Locality b Box Locality a Locality b State tax withheld State distribution Local tax withheld Locality name 6 Local distribution

20 NYG New York Certain Government Payments Recipient's SSN Recipient's name NYG () NY6 Income and Withholding Information Payer information: EIN Name line Name line Street 6 City, state, zip code Telephone number Foreign: Country code / description Province or county Postal code Telephone number Recipient: Street 6 City, state, zip code Account number Tax year Corrected Void Income type: Unemployment compensation Refunds or offsets Trade or business income RTTA payments Agriculture payments Market gain Taxable grants Repayment amount Federal income tax withheld First state income and withholding Second state income and withholding Local income and withholding City Code State Income City Withholding Amount State ID Number 6 6 Withholding

21 NYELF New York Electronic Filing NYELF () Fiduciary Income Tax Information Consent to disclose information: By using a computer system and software to prepare and transmit my client's return electronically, I consent to the disclosure of all information pertaining to my use of the system and software to create my client's return and to the electronic transmission of my client's tax return to the New York Department of Taxation and Finance, as applicable by law. NY Suppress electronic file when filing federal return or extension electronically Form TR-.-IT has already been signed and returned Signature date for return if different from federal ERO signature date if different from signature date or federal ERO signature date Form TR-.-IT has already been signed and returned Signature date for electronic funds withdrawal if different from federal ERO / Preparer Authorization Declaration authorization for return Authorization for electronic funds withdrawal for extension and estimates I certify that I have a valid New York State E-File Signature Authorization for Tax Year (Form TR-.-IT), authorizing me to sign and file this return on behalf of the fiduciary(s). I further certify that all information provided on the return is true, correct and complete; to the best of my knowledge and belief, and that I have provided a copy of this return to the fiduciary(s). If financial institution account information has been provided on the return, I certify that the fiduciary(s) has agreed to payment of the amount indicated as due by electronic funds withdrawal, that the fiduciary(s) has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the indicated account, and that the designated financial institution is authorized to debit the entry to the fiduciary(s) account. I understand and agree that I may revoke this authorization for payment only by contacting the Tax Department no later than five () business days prior to the payment date. By checking the box, I understand and agree that I am electronically signing and filing this return. By checking the box, I certify that I am electronically signing and filing this request for an extension or estimate(s). I certify that I have a valid New York State Taxpayer Authorization Electronic Funds Withdrawal for Tax Year Form IT-0-PF and Tax Year Form IT-6 (Form TR-.-IT), authorizing me to submit this extension or estimates(s) on behalf of fiduciary(s). I certify, to the best of my knowledge and belief, that all information provided is true, correct and complete and that I have provided a copy of this request for an extension or estimate(s) to the fiduciary. If financial institution account information has been provided on the request for an extension or estimate(s), I certify that the fiduciary has agreed to payment of the amount(s) indicated as due by electronic funds withdrawal, that the fiduciary has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the indicated financial institution account(s), and that the designated financial institution(s) is authorized to debit the entry to the account(s). I understand and agree that I may revoke this authorization for payment only by contacting the Tax Department no later than () business days prior to the payment date. Self-filer Authorization Enter name 6 Declaration authorization for return Authorization for electronic funds withdrawal for extension and estimates By checking the declaration box, under penalty of perjury, I declare that I have examined the information on this New York State electronic fiduciary income tax return, including any accompanying schedules, attachments, and statements, and certify that the electronic return is true, correct, and complete. If I am paying the New York State fiduciary income taxes owed by electronic funds withdrawal, I authorize the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on this electronic return, and I authorize my financial institution to debit the entry to the account. I understand and agree that I may revoke this authorization for payment only by contacting the Tax Department no later than five () business days prior to the payment date. By entering my name and checking the box, I declare that I am an authorized fiduciary of this estate or trust, that I am authorized to sign and file this electronic return on behalf of the estate or trust, and am in fact signing and filing this return. By checking the authorization box, I certify that I am electronically signing and filing this request for an extension or estimate(s). I certify that all information provided on the request for an extension or estimate(s) is true, correct and complete, and that I am authorized to file this request for an extension or estimate(s). If financial institution account information has been provided on the request for an extension or estimate(s), I agree to payment of the amount(s) indicated by electronic funds withdrawal, that I authorize the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the indicated financial institution account(s), and that the designated financial institution(s) is authorized to debit the entry to the account(s). I understand and agree that I may revoke this authorization for payment only by contacting the Tax Department no later than () business days prior to the payment date.

22 NYW New York Wage Information NYW () NY EIN Name Employer's: Address City, state, zip code Form W- Information 6 Wages, tips Allocated tips Dependent care benefits Nonqualified plans a Amount Code b Amount Code c Amount Code 6 d Amount Code Statutory employee Retirement plan Third-party sick pay a Amount Description b Amount Description c Amount 6 Description d Amount Description Corrected W- 0 6 a b a b Locality a Locality b Locality a Locality b Locality a Locality b State a b State wages, tips, etc. (for NYS) New York State income tax withheld 6 Local wages, tips, etc. Local income tax withheld 0 Name of locality Code

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