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Caution: Carefully review the Social Security information for yourself and your children. To be eligible to claim the New York State and New York City EIC, you must provide valid SSNs by the due date of the return (including extensions). If you are claiming a person with a disability, you may be required to provide supporting documentation stating that the qualifying person was permanently disabled during the tax year. Line 6: Complete Worksheet A to determine the amount to enter on line 6. Line 7: Enter on line 7 any amount you received as a Medicaid waiver payment that you excluded on your federal return and want to exclude from your earned income. Line 8: Complete only if you filed federal Form 1040, Schedule 1, Additional Income and Adjustments to Income. Enter the amount of business income or loss (the total of lines 1e, 2c, and 3) from your federal Form 1040 instructions, Earned Income Credit Worksheet B. Use a minus sign to show a loss or a negative amount. Be sure to enter the employer identification number (EIN) for your business. If you have income or loss from more than one business, enter the EIN representing your primary business activity. If your primary business activity does not have an EIN, enter your SSN. Line 12: This amount represents your New York State EIC before subtracting the amount of household credit allowed. If the amount on line 12 is more than zero and you are a full-year or part-year New York City resident, also calculate your New York City EIC. Line 16: Allowable New York State earned income credit. • Residents: Enter the amount on Form IT-201, Resident Income Tax Return, line 65. • Nonresidents: Enter the amount on Form IT-203, Nonresident and Part-Year Resident Income Tax Return, line 43. • Part-year residents: Enter the amount on Form IT-203, line 43, and continue on line 18. Caution: If you are a married couple filing a joint federal return but you are filing separate New York State returns, the line 16 amount is the total combined New York State EIC for both spouses. You must complete line 17 and indicate the amount of line 16 that you are claiming on your return. Line 17: Complete this line only if you filed a joint federal return but are required to file separate New York State returns. See the Wages, salaries, tips, etc. 1. Enter the amount from federal Form 1040, line 1z; or

if you are a member of the clergy or a church employee who checked the Yes box in step 5, line 1, of the federal Form 1040 instructions for line 27a, enter the amount from step 5, line 1, of the federal Form 1040 instructions ............................................ 1. 2. Enter the amount of your nontaxable combat pay, if any, from federal Form 1040, line 1i ...................................... 2. 3. Add lines 1 and 2. Enter here and on Form IT-215, line 6 ............................. 3. Worksheet A General information Who qualifies Generally, if you claimed the federal earned income tax credit, you qualify for the New York State earned income credit (EIC). If you were a full-year or part-year resident of New York City, you also qualify for the New York City EIC. You may qualify for the New York City EIC even if you do not qualify for the New York State EIC. Noncustodial parents You may qualify for the noncustodial parent New York State earned income credit instead of the New York State EIC if you: • are a full-year New York State resident, • are a noncustodial parent, and • pay child support through a New York State Support Collection Unit. For further information on this credit, see Form IT-209, Claim for Noncustodial Parent New York State Earned Income Credit. How to claim the credit To claim the New York State or New York City EIC, you must: • complete Form IT-215 using the information from your federal: return, worksheets, and income tax credit line instructions, and • file it with your New York State income tax return. To claim the New York City EIC, you must also complete Worksheet C, New York City earned income credit. Line instructions All filers must complete lines 1 through 17 as applicable. Part-year New York State resident filers must also complete lines 18 through 26. New York City residents and part-year residents must also complete lines 27 and 28. Line 1: You must have claimed the federal earned income tax credit to claim the New York State and New York City EIC. Line 2: If your investment income is more than $11,950, you cannot claim the New York State and New York City EIC. For most people, investment income is the total amount of: • taxable interest (from line 2b of federal Form 1040); • tax-exempt interest (from line 2a of federal Form 1040); • ordinary dividends income (from line 3b of federal Form 1040); and • capital gain net income (from line 7a of federal Form 1040) if more than zero. For additional information on what qualifies as investment income, see federal Publication 596, Earned Income Credit. Line 4: If you claimed qualifying children on your federal Schedule EIC, list each child’s name including suffix (for example, Jr., Sr., III) in the spaces provided on line 4. If you claimed more than three qualifying children on your federal Schedule EIC: 1. Enter the required information for the first three qualifying children in the spaces provided on the form. 2. Provide the required information on each additional child on a separate statement and include your name and Social Security number (SSN). 3. Submit the statement with Form IT-215. IT-215-I Department of Taxation and Finance Instructions for Form IT-215 Claim for Earned Income Credit New York State • New York City