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IT-216-I (2025) Page 3 of 7 Child support payments received by you are not included in your gross income and are not considered as earned income for calculating this credit. If you are filing a joint federal return, disregard community property laws in determining the earned income of an individual. If your spouse died during the tax year and had no earned income, see federal Publication 503. If you or your spouse was a student or disabled in the tax year, see the lines 6 and 7 instructions on page 5. Line instructions New York State resident, nonresident, and part-year residents complete lines 1 through 14. Part-year New York State residents must also complete lines 15 through 22. New York City residents and part-year residents must also complete lines 23 through 30, as applicable. Line 1 – Mark an X in the Yes box, only if your New York State filing status is Married filing separate return and you checked box A on your federal Form 2441, stating you meet the requirements to be considered unmarried for the purposes of the federal child and dependent care credit. Line 2 – Complete boxes A through D for each person or organization that provided the care. If you have more than two providers, enter the required identifying information for two providers in the spaces provided on the form. Submit a statement with your return with the same required identifying information for the additional providers. Be sure to put your name and Social Security number (SSN) on the statement. You can use federal Form W-10, Dependent Care Provider’s Identification and Certification, or any other source listed in its instructions to get the information from the care provider. If you do not give correct or complete information, your credit may be disallowed unless you can show you used due diligence (a serious and earnest effort) in trying to get the required information. You can show due diligence to get the information by keeping in your records a federal Form W-10 completed by the care provider; or, you may keep one of the other sources of information listed in the instructions for federal Form W-10. If the provider does not give you the information, complete the entries you can on line 2 of Form IT-216. For example, enter the provider’s name and address. Write See explanation in the boxes for which you do not have the information. Then, submit an explanation with your Form IT‑216 indicating that the care provider did not give you the information you requested. Line 2 boxes A and B – Enter the care provider’s name and address. If you were covered by your employer’s dependent care plan, and your employer furnished the care (either at your workplace or by hiring a care provider), enter your employer’s name in box A. Next, write See W-2 in box B. Then leave boxes C and D blank. If your employer paid a third party (not hired by your employer) on your behalf to provide the care, you must give information on the third party in boxes A through D. Line 2 box C – If the care provider is an individual, enter their SSN. Otherwise, enter the provider’s employer identification number (EIN). If the provider is a tax-exempt organization, write TAXEXEMPT in box C. Line 2 box D – Enter the total amount you actually paid to the care provider. Also include amounts your employer paid to a third party on your behalf. It does not matter when the expenses were incurred. Do not reduce this amount by any reimbursement you received. Line 3 – Enter the total number of qualifying persons you are claiming. Complete columns A through F for each qualifying person. List the qualifying persons in order from youngest to oldest. Enter the required information for up to five qualifying persons in the spaces provided on the form. If you have more than five, list the required information for all additional qualifying persons in the same format on a separate sheet of paper. Write your name and SSN on all additional sheets and submit them with Form IT-216. Line 3 columns A and B – List the name of the qualifying person you are claiming, including suffix (for example, Jr., Sr., III). Line 3 column C – Enter all qualified expenses you incurred and paid for the person listed in columns A and B. Do not include in column C the following expenses: 1. Qualified expenses you incurred in 2025 but did not pay until 2026. However, next year you may be able to use these expenses to increase your 2026 credit. 2. Qualified expenses you incurred in 2024 but did not pay until 2025. If you had prior year expenses you did not pay until 2025, see the instructions for line 11. 3. Qualified expenses prepaid in 2025 for care to be provided in 2026. These expenses can only be used to calculate your 2026 credit. 4. Expenses you paid through a dependent care account. Note: It is possible to have no expenses for a qualifying person. You should enter 0 for qualifying persons with no expenses and the actual amount for any others. For more information, see Qualified expenses on page 2. Line 3 column D – Mark an X in the box in column D, Person with disability, if the qualifying person had a disability and was incapable of caring for themself. Note: You may be required to provide supporting documentation showing that the qualifying person was incapable of caring for themself during the period the care was provided. Line 3 column E – Enter the qualifying person’s SSN. Caution: To be eligible to claim the New York State child and dependent care credit, you must provide a valid SSN for each person listed on your tax return. If the Internal Revenue Service has issued you an individual taxpayer identification number (ITIN) because either you or a qualifying person claimed on Form IT-216 is a resident or nonresident noncitizen, enter this ITIN in place of the SSN. If you have applied for a SSN by filing federal Form SS-5, Application for a Social Security Card, with the Social Security Administration, or you have applied for an ITIN by filing federal Form W-7, Application for IRS Individual Taxpayer Identification Number, with the IRS, but you have not received your SSN or ITIN by the due date of your return, you can either: 1. File Form IT-370, Application for Automatic Six-Month Extension of Time to File for Individuals, to request an automatic extension of time to file. (This extension does not give you any extra time to pay any tax owed. You should pay any New York taxes you expect to owe to avoid interest or penalty charges. For more information, see Form IT-370.) 2. File your return on time without claiming the child and dependent care credit and do not file Form IT-216. After receiving the SSN or ITIN, file an amended return and include Form IT-216 to claim the credit. Line 3 column F – Enter the qualifying person’s date of birth. Line 3b – Complete Worksheet 1 if you received dependent care benefits from your employer. If you did not receive dependent care benefits from your employer, leave line 3b blank.