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New York Free Printable Form IT-221 Disability Income Exclusion Tax Year 2023 for 2024 New York Disability Income Exclusion

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Disability Income Exclusion
Form IT-221 Disability Income Exclusion Tax Year 2023

IT-221 Department of Taxation and Finance Disability Income Exclusion New York State  •  New York City  • Yonkers Submit this form with Form IT-201 or IT-203. Name(s) as shown on your return Social Security number For limits on exclusion, see instructions, Form IT-221-I. Employer’s name Date you retired (if after December 31, 1976). Also enter this date in the space provided on the Physician’s statement on back. Yourself Your Spouse  (also give payer’s name, if other than employer) Date of retirement Date of retirement Mark an X in the box if you did not live with your spouse during any part of the tax year. Which column(s) to fill in – Use Column A to enter your disability income amounts. If you are married and your spouse also received disability income, enter your spouse’s amounts in Column B. If you checked filing status , Married filing separate return, see instructions. Column A (yourself) Column B (your spouse) 1 Enter total disability pay you received during this tax year ............ 1 .00 1 Excludable disability pay (see instructions) 2 Multiply $100 by the number of weeks for which your disability   payments were at least $100. Enter total.................................... 2 .00 2 3 If you received disability payments of less than $100 for any   week, enter the total amount you received for all such weeks.... 3 .00 3 4 If you received disability payments for less than a week, enter   the smaller amount of either the amount you received or the   highest exclusion allowable for the period (see instructions) ........ 4 .00 4 5 Add lines 2, 3, and 4. Enter the total.............................................. 5 .00 5 6 Add amounts on line 5, columns A and B. Enter the total............................................................... 6 .00 .00 .00 .00 .00 .00 Limit on exclusion (see instructions) 7 Enter amount from Form IT-201, line 19, or   Form IT-203, line 19, Federal amount column ........................................................................... 7 .00 8 Amount used to figure any exclusion decrease ............................................................................. 8 15000.00 9 Subtract line 8 from line 7. If line 8 is larger than line 7, enter 0 .................................................... 9 .00 10 Subtract line 9 from line 6. If line 9 is larger than line 6, stop;   you cannot claim any disability income exclusion ...................................................................... 10 .00 11 Enter line 10 amount in Column A. This is your disability income Column A (yourself) Column B (your spouse)   exclusion. However, if both spouses received disability pay,   see instructions for proration. ..................................................... 11 .00 11 .00 Transfer the total of columns A and B to Form IT-225, line 10, Total amount column and enter subtraction modification S-124 in the Number column. Statement of permanent and total disability If you filed a Physician’s statement for this disability for tax year 1984, or you filed a Physician’s statement for tax years after 1984 and your physician marked an X in box B on the Physician’s statement, and due to your continued disabled condition you were unable to engage in any substantial gainful activity in this tax year, mark an X in this box ........... If you marked the box above, you do not have to file another Physician’s statement for this tax year. If you did not mark the box above, have your physician complete the Physician’s statement on the back of this form, and submit both front and back pages with your return. 221001230094 IT-221 (2023) (back) Physician’s statement I certify that: Name of patient was permanently and totally disabled on January 1, 1976; or January 1, 1977; or was permanently and totally disabled on the date they retired Date retired if after December 31, 1976 (mmddyyyy) Mark an X in box A or B below and sign. Mark only one box. A The disability has lasted or can be expected to last continuously for at least a year............. Physician’s signature Date B There is no reasonable probability that the disabled condition will ever improve................ Physician’s signature Date Physician’s name (print or type) Physician’s address Instructions for Physician’s statement Taxpayer Enter in the space provided the date you retired if after December 31, 1976. If required, your physician must complete the above statement. File both front and back pages of this form with your tax return. If both spouses take the exclusion, a Physician’s statement must be completed for each spouse. If you retired on disability before January 1, 1977, the Physician’s statement must show that you were permanently and totally disabled on January 1, 1976, or January 1, 1977. If you retired on disability after 1976, the Physician’s statement must show that you were permanently and totally disabled when you retired. 221002230094 Physician A person is permanently and totally disabled when they cannot engage in any substantial gainful activity because of a physical or mental condition, and a physician determines that the disability: – has lasted or can be expected to last continuously for at least a year; or  – can be expected to lead to death. Complete the statement area above, sign the form, and return it to the taxpayer to submit with their return.
Extracted from PDF file 2023-new-york-form-it-221.pdf, last modified October 2006

More about the New York Form IT-221 Individual Income Tax Tax Credit TY 2023

This is a form to be filled by those who are disabled and receiving pay due to their disability.

We last updated the Disability Income Exclusion in January 2024, so this is the latest version of Form IT-221, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form IT-221 directly from TaxFormFinder. You can print other New York tax forms here.

Other New York Individual Income Tax Forms:

TaxFormFinder has an additional 271 New York income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form IT-201 Individual Income Tax Return
IT-201-V Payment Voucher for Income Tax Returns
Form IT-201-D Resident Itemized Deduction Schedule (DISCONTINUED)
Form IT-203 Nonresident Income Tax Return
Form IT-201-I Individual Income Tax Return Instructions

Download all NY tax forms View all 272 New York Income Tax Forms


Form Sources:

New York usually releases forms for the current tax year between January and April. We last updated New York Form IT-221 from the Department of Taxation and Finance in January 2024.

Show Sources >

Form IT-221 is a New York Individual Income Tax form. States often have dozens of even hundreds of various tax credits, which, unlike deductions, provide a dollar-for-dollar reduction of tax liability. Some common tax credits apply to many taxpayers, while others only apply to extremely specific situations. In most cases, you will have to provide evidence to show that you are eligible for the tax credit, and calculate the amount of the credit to which you are entitled.

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of New York Form IT-221

We have a total of twelve past-year versions of Form IT-221 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form IT-221

Form IT-221 Disability Income Exclusion Tax Year 2023

2022 Form IT-221

Form IT-221 Disability Income Exclusion Tax Year 2022

2021 Form IT-221

Form IT-221 Disability Income Exclusion Tax Year 2021

2020 Form IT-221

Form IT-221:2020:Disability Income Exclusion:it221

2019 Form IT-221

Form IT-221:2019:Disability Income Exclusion:it221

2018 Form IT-221

Form IT-221:2018:Disability Income Exclusion:it221

2017 Form IT-221

Form IT-221:2017:Disability Income Exclusion:it221

2016 Form IT-221

Form IT-221:2016:Disability Income Exclusion:IT221

2015 Form IT-221

Form IT-221:2015:Disability Income Exclusion:IT221

Disability Income Exclusion 2014 Form IT-221

Form IT-221:2014:Disability Income Exclusion:IT221

Disability Income Exclusion 2013 Form IT-221

Form IT-221:2013:Disability Income Exclusion:IT221

2012 Form IT-221

Form IT-221:2012:Disability Income Exclusion:IT221


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