Resume

Income Tax Credit

Location:

New York, NY

Posted:

January 24, 2024

Contact this candidate

Resume:

**** **-*** ****** ************

AUDIE A DE LA CRUZ

Form filed:

IT-201 and supplemental forms and schedules

Filing method:

Your return will be e-filed, do not mail your return Due date:

**-**-***2

Refund:

$239.00

Transaction 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.

2021

New York State Income Tax Return Other New York and New York City Returns New York Return Summary

Unincorporated Business Tax (NYC-202)

Advanced Payments Received

Income, Adjustments and Deductions

LLC and LLP Filing Fee

Nonresident Employee of the

City of New York (NYC 1127)

Tax, Payments, and Credits

Miscellaneous Information

Taxpayer Spouse

Amount due or -refund

Amount refunded

Overpayment applied

Total balance due

Form IT-204-LL, amount due

Taxable income

MCTMT net earnings base

MCTMT

Refundable Credits claimed

Total refundable credits

Refund

Overpayment applied to next year

Amt as a NYS 529 account deposit

Amount refunded

Amount due

(Keep for your records)

Daytime Phone #

City State Zip Email

Form Filed

Filing Status

NYS Residency Taxable income

NYC Residency Tax

Yonkers Residency Credits

Estimate and extension payments

Property tax freeze credit

Underpayment of estimates

Federal adjusted gross income (FAGI) Failure to pay penalty FAGI (NYS Column - IT-203 filers) Failure to file penalty Total additions Late filing interest

Total Subtractions

New York AGI

NY AGI (NYS Col - IT-203 filers)

Itemized or standard deduction

Dependent Exemptions

Taxable income

New York State tax

Tax

Nonrefundable state credits

Credits and withholdings

Net other state taxes

Balance due

Total NYS tax

Refund

New York City taxes

New York City nonrefundable credits

Yonkers taxes

Use 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 number

NY_SUM.LD

Your Name

Spouse's Name Spouse's social security number

Mailing address Apartment number

...

AUDIE A DE LA CRUZ 128 58 4975

1749 GRAND CONCOURSE 1Q 917-***-****

BRONX NY 104538241 ad22v1@r.postjobfree.com

IT-201

SINGLE

FULL-YEAR RESIDENT

RESIDENT

NONRESIDENT

52432.

X 8000.

44432.

2417.

1600.

4017.

63.

4098.

4256.

63.

239. 95.

239.

Office of Processing and Taxpayer Services

W A Harriman Campus, Albany NY 12227-0865

TR-573.2 (6/18)

Department of

Taxation and Finance

Most 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.gov

Attention tax return preparer:

Attention taxpayer:

Questions?

1024

Your 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 • MCTMT

For help completing your return, see the instructions, Form IT-201-I. A Filing D1

status

H Dependent information

(mark an

X in one

box):

If more than 7 dependents, mark an X in the box.

Resident Income Tax Return IT-201

For the full year January 1, 2021, through December 31, 2021, or fiscal year beginning ... 21 and ending ...

NYC residents and NYC part-year

residents only

code(s) if applicable

Did you have a financial account located in a

Single foreign country? Yes No

Married filing joint return Were you required to report any nonqualified deferred compensation, as required by IRC § 457A,

on your 2021 federal return? Yes No

Married filing separate return

Yes No

Head of household

Qualifying widow(er)

Did you itemize your deductions on

your 2021 federal income tax return? Yes No

Can you be claimed as a dependent

on another taxpayer's federal return? Yes No

Enter your 2-character special condition

(see page 14)

First name MI Last name Relationship Social Security number For office use only

Your 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 district

code number

City, village, or post office State ZIP code Taxpayer's date of death (mmddyyyy) Spouse's date of death (mmddyyyy) Decedent

information

(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 061*****-***-** 4975

1749 GRAND CONCOURSE 1Q BRONX

BRONX NY 10453 8241 BRONX

068

X X

X 12

201*********

Rental 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 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

15 15

16 16

17 17

18 18

19 19

19a 19a

20 20

21 21

22 22

23 23

24 24

25 25

26 26

27 27

28 28

29 29

30 30

31 31

32 32

33 33

Standard - or - Itemized 34

35 35

36 36 000.00

37 37

Wages, salaries, tips, etc. .00

Taxable interest income .00

Ordinary dividends .00

Taxable refunds, credits, or offsets of state and local income taxes (also enter on line 25) .00 Alimony received .00

Business 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

.00

Rental real estate included in line 11 .00

Farm income or loss (submit a copy of federal Schedule F, Form 1040) .00 Unemployment compensation .00

Taxable amount of Social Security benefits (also enter on line 27) .00 Other income .00

Add lines 1 through 11 and 13 through 16 .00

Total federal adjustments to income .00

Federal 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) .00

Add lines 19a through 23 .00

.00

Taxable amount of Social Security benefits (from line 15) .00 Interest income on U.S. government bonds .00

Pension and annuity income exclusion (see page 17) .00 New York's 529 college savings program deduction/earnings .00 Other (Form IT-225, line 18) .00

Add lines 25 through 31 .00

New 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: .00

Subtract 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 only

Your Social Security number

(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 4975

52432

X 8000

44432

201*********

(Form IT-360.1)

Tax computation, credits, and other taxes

New York City and Yonkers taxes, credits, and surcharges, and MCTMT See instructions on

pages 21 through 24 to

compute New York City and

Yonkers taxes, credits, and

surcharges, and MCTMT.

IT-201 (2021) Page 3 of 4

38 38

39 39

40 40

41 41

42 42

43 43

44 44

45 45

46 46

47 47

47a 47a

48 48

50 50

51 51

52 52

53 53

54a

54b 54b

55 55

56 56

57 57

58 58

59 59

60 60

61 Total New York State, New York City, Yonkers, and sales or use taxes, MCTMT, and 61

Name(s) as shown on page 1

Taxable income (from line 37 on page 2) .00

NYS tax on line 38 amount (see page 20) .00

NYS household credit (page 20, table 1, 2, or 3) .00 Resident credit (see page 21) .00

Other NYS nonrefundable credits (Form IT-201-ATT, line 7) .00 Add lines 40, 41, and 42 .00

Subtract 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) .00

NYC resident tax on line 47 amount (see page 21) .00 NYC household credit (page 21) .00

Subtract line 48 from line 47a (if line 48 is more than line 47a, leave blank) .00

Part-year NYC resident tax (Form IT-360.1) .00

Other NYC taxes (Form IT-201-ATT, line 34) .00

Add lines 49, 50, and 51 .00

NYC 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) .00

MCTMT net

earnings base .00

MCTMT .00

Yonkers resident income tax surcharge (see page 24) .00 Yonkers nonresident earnings tax (Form Y-203) .00

Part-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 4975

44432

2417

44432

1600

4017

201*********

Third-party

designee?

(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 credits

Your refund, amount you owe, and account information Taxpayer(s) must sign here

See instructions for where to mail your return.

Page 4 of 4 IT-201 (2021)

62 62

63 63

64 64

65 65

66 66

67 67

68 68

69 69

69a 69a

70 70

70a 70a

71 71

72 72

73 73

Do not send federal Form W-2

74 74

with your return.

75 75

76 76

77 77

78 78

78a 78a

78b 78b

paper

Mark one refund choice: - or - check

80 See page 31 for payment options.

81 See page 36 for the proper

82 82 assembly of your return.

83a - or - - or - - or -

83b 83c

Yes No

Paid preparer must complete

Enter amount from line 61 .00

(see pages 26 through 29)

Empire State child credit .00

NYS/NYC child and dependent care credit .00

NYS earned income credit (EIC) .00

NYS noncustodial parent EIC .00

Real property tax credit .00

College tuition credit .00

NYC school tax credit (fixed amount) .00

NYC school tax credit (rate reduction amount) .00

NYC earned income credit .00

This line intentionally left blank

Other 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 .00

Total Yonkers tax withheld .00

Total 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 or

savings account (fill in line 83) Refund? Direct deposit is the easiest, fastest way to get your

Amount of line 77 that you want applied to your 2022 refund. estimated tax (see instructions) .00

Amount you owe (if line 76 is less than line 62, subtract line 76 from line 62). To pay by electronic funds withdrawal, mark an X in the box and fill in lines 83 and 84. 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) .00

Account 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 number

Electronic funds withdrawal (see page 32) Date Amount .00

(see instructions)

Your Social Security number

(see instr.)

Preparer's NYTPRIN NYTPRIN

excl. code

Preparer'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 number

Email: Email:

NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM. 128 58 4975 4017

2402

1696

4256

239

ROSEMARY RODRIGUEZ 718-***-****

X ad22v1@r.postjobfree.com 11685

12424627

ROSEMARY RODRIGUEZ

LIBERTY TAX OFFICE 13786 P02011685 SECURITY GUARD

425 E 149TH ST 84 3022768

BRONX NY 104**-******** 917-***-****

ad22v1@r.postjobfree.com ad22v1@r.postjobfree.com

201*********

Locality a Locality a Locality a

Locality b Locality b Locality b

Locality a Locality a Locality a

Locality b Locality b Locality b

Box 15a

Box 15b

Box 15a

Box 15b

Box c Employer's information

Employer's name

Box a Employee's Social Security number

for this W-2 Record Employer's address

Box 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 State

Box 16b Other state wages, tips, etc. Box 17b Other state income tax withheld other state

Box 18 Local wages, tips, etc. Box 19 Local income tax withheld Box 20 Locality name Box c Employer's information

Employer's name

Box a Employee's Social Security number

for this W-2 Record Employer's address

Box 16b Other state wages, tips, etc. Box 17b Other state income tax withheld other state

Box 18 Local wages, tips, etc. Box 19 Local income tax withheld Box 20 Locality name New York State • New York City • Yonkers

Do not detach or separate the W-2 Records below. File Form IT-2 as an entire page with your return. See instructions. N Y

N Y

Summary of W-2 Statements IT-2

W-2 Record 1

W-2 Record 2

Do not detach.

Department of Taxation and Finance

.00 .00 .00

Corrected (W-2c)

NY State information:

.00 .00

Other state information:

.00 .00

NYC and Yonkers

information (see instr.):

.00 .00

.00 .00 .00

Corrected (W-2c)

NY State information:

.00 .00

Other state information:

.00 .00

NYC and Yonkers

information (see instr.):

.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 INC

128-**-****-*** E 175TH STREET

26 0076866 BRONX NY 10457 0000

52432 31 C

1069 D

369 A A

52432 2402

52432 1696 NYC

102*********

2021

New York New York City school tax credit (NYC residents only) Worksheet

Table 1 - Full-year New York City residents:

New York City school tax credit table

If your income Your

Filing status: credit* is:

$ 63

$ 125

Table 2 - Part-year New York City residents:

New York City school tax credit proration chart

New York City school tax credit worksheet

(Keep for your records)

(see below) is:

Single, filing status (1), or

Married filing separate

return, filing status (3), or $250,000 or less

Head of household,

filing status (4)

Married filing joint

return, filing status (2)

Qualifying widow(er) $250,000 or less

filing 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 $ 10

2 10 21

3 16 31

4 21 42

5 26 52

6 31 63

7 36 73

8 42 83

9 47 94

10 52 104

11 57 115

12 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 number

NYWK_STC.LD

Name(s) as shown on return

Resident

period

(number

months)

AUDIE A DE LA CRUZ 128 58 4975

63.

1024

Calculation 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 and

married filing separately

Calculation of NYC school tax credit

(rate reduction amount) for head of household

Must be a NYC Full or Part Year Resident.

Taxable income must not be more than $500,000

2021

New York NYC School Tax Credit (Rate Reduction Amount) Worksheet: Worksheet

If 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:

2 If only one spouse was a full-year resident of NYC: 2

3 3

$ 0 $ 21,600 .171% of taxable income

21,600 500,000 $ 37 plus .228% of the excess over $21,600

$ 0 $ 12,000 .171% of taxable income

12,000 500,000 $ 21 plus .228% of the excess over $12,000

$ 0 $ 14,400 .171% of taxable income

14,400 500,000 $ 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 2

NYC 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 number

NYCSTCWK.LD

Name(s) as shown on return

AUDIE A DE LA CRUZ 128 58 4975

44432.

95.

Department of Taxation and Finance

Taxpayer's name Spouse's name

(from applicable line)

Taxpayer's signature Date

Spouse's signature Date

ERO's signature Print name Date

Paid preparer's signature Print name Date

TR-579-IT (9/21)

1024

New York State E-File Signature Authorization for Tax Year 2021 www.tax.ny.gov

For Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, and NYC-210 Purpose

General instructions

Part A - Tax return information

Part 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.

EROs 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 taxpayer’s 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 income

Refund

Amount you owe

Financial institution routing number

Financial institution account number

Account 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 ERO’s 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 taxpayer’s 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)

AUDIE A DE LA CRUZ

FORM IT-201

52432.

239.

04102023

ROSEMARY RODRIGUEZ 04102023

NYWK_AGI 2021

For your records only.

Adjusted Gross Income Split Worksheet

Federal 1040 Income and Adjustments

Federal 1040

Schedule 1 - Additional Income

Schedule 1 - Adjustments to Income

AGI

Summary

Name(s) as shown on state return Social Security Number Federal State

1 1

2b 2b

3b 3b

4b 4b

5b 5b

6b 6b

7 7

8 8

9 9

10 10

11 11

2a 2a

3 3

4 4

6 6

7 7

8 8

10 10

11 11

13 13

14 14

15 15

17 17

18 18

19a 19a

20 20

21 21

22 22

23 23

24 24

26 26

Col. A Col. B Col. A Col. B

Wages, salaries, tips, etc.

Taxable interest

Ordinary dividends

Taxable amount of IRA distributions

Taxable amount of Pensions and annuities

Taxable amount of Social security benefits

Capital gain or (loss)

Other income from Schedule 1

Total income (Sum of Lines 1-8)

Adjustments to income from Schedule 1

Adjusted Gross Income (line 9 - line 10)

Taxable refunds, credits, or offsets

of state and local income taxes

Alimony received

Business income or (loss)

Other gains or (losses)

Rental real estate, royalties, partnerships,

S corporations, trusts, etc.

Farm income or (loss)

Unemployment compensation

Other income.

Total Additional Income (Sum of lines 1-8)

Educator Expenses

Certain business expenses of reservists,

performing artists, & fee-basis gov. officials

Health savings account deduction

Moving expenses

Deductible part of self-employment tax

Self-employed SEP, SIMPLE, and

qualified plans

Self-employed health insurance deduction

Penalty on early withdrawal of savings

Alimony paid

IRA deduction

Student loan interest deduction

Reserved

Archer MSA Deduction

Other Deductions (see STWK_ADJ)

Total Adjustments to income (Sum of lines 11-24)

NYWK_AGI.LD

FD/ST

AUDIE A DE LA CRUZ ***-**-****

Taxpayer Spouse Taxpayer Spouse

52,432 52,432

2021

Three-year State Tax Return Comparison

NY-COMP

[State] Income Tax Return 201*-****-**** Difference 2020-2021 Name(s) as shown on return Taxpayer ID Number

Filing Status

Gross Income

Additions

Subtractions

Exemptions

Standard Deduction

Itemized Deduction

Deductions

Taxable Income

Actual State Income

State Income Tax

Local Taxes

Use Tax

Contributions

Income Tax Withheld

Estimates and Extension payments

Underpayment Penalty

Overpayment Applied to Next Year

Refund

Balance Due

Marginal tax rate

Effective tax rate

NY-COMP.LD

...

AUDIE A DE LA CRUZ ***-**-****

52,432 52,432

8,000 8,000

44,432 44,432

4,017 4

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