New York State Department of Taxation and Finance IT-2663 Nonresident Real Property Estimated Income Tax Payment Form (12/11) For use on sale or transfer of real property by a nonresident of New York State Tax Law — Article 22, Section 663 Submit your completed Form IT-2663 with full payment of estimated tax due, if any, to the recording officer For office use only at the time the deed is presented to be recorded. Do not mail Form IT-2663 to the Tax Department. Do not use Form IT-2663 for the sale, transfer, or other disposition of shares of stock by a nonresident in a cooperative housing corporation. Use Form IT-2664, Nonresident Cooperative Unit Estimated Income Tax Payment Form, instead. This form is valid for sales or transfers (date of conveyance) after December 31, 2011, but before January 1, 2013. A The transferor/seller is: an individual an estate or trust B Is the transferor/seller reporting the gain for federal income tax purposes under the installment method? Yes No   If Yes, what is the duration of the installment agreement? months years C Mark an X in the box if only a portion of the real property being sold or transferred qualifies as the principal residence of the transferor(s)/seller(s) listed below. Part 1 — Sale or transfer information (see Form IT-2663-I, Instructions for Form IT-2663, for assistance) Transferor/seller name Transferor/seller identification number ( SSN or EIN ) Spouse’s name or name of fiduciary ( if applicable ) Spouse’s SSN Address of transferor/seller ( number and street; see instructions ) City State ZIP code Mailing address of transferor/seller or fiduciary ( if different ) City State ZIP code Location and description of property transferred ( include county and tax map number )   Date of conveyance Tax map designation Section Block Lot – – 2012 Part 2 — Estimated tax information ( Complete Worksheet for Part 2 on page 2 before completing this part.) 1 Sale price ( from Worksheet for Part 2, line 15 ) . ................................................................................................ 1. . 2 Total gain ( from Worksheet for Part 2, line 17; if a loss, enter 0 ) .......................................................................... 2. 00 . 3 Estimated tax due ( from Worksheet for Part 2, line 20 ) . ................................................................................. 3. Part 3 — Nonpayment of estimated tax by a nonresident upon sale of real property (see instructions) 4 This is to certify that the transferor/seller of this property is a nonresident of New York State and is not required to pay estimated tax under Tax Law section 663 due to one of the following reasons: A The sale or transfer of this property results in a loss ( less than or equal to zero) for federal income tax purposes ( you   must complete Worksheet for Part 2 on page 2 of this form ). B The transferor/seller is not required to recognize any gain or loss with respect to the transfer under provisions of the   Internal Revenue Code ( IRC ) (except for section 121) ( you must complete the summary below ). Brief summary of the transfer ( include the section( s) of the IRC and facts supporting the claim that the recognition of the gain or loss is not required with respect to the sale or transfer ): Part 4 — Signature I, the undersigned, certify that this form including any certification and attachment(s), is to the best of my knowledge and belief, true, correct, and complete. Signature of transferor/seller Date Signature of spouse ( if applicable ) Date American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3  IT-2663 (12/11) Worksheet for Part 2 Use this worksheet to compute your gain or loss on the sale or transfer of the real property. The gain or loss is computed in the same manner as for federal income tax purposes. For more information, see federal Publication 523, Selling Your Home; Publication 544, Sales and Other Dispositions of Assets; and Publication 551, Basis of Assets. These publications are available on the Internal Revenue Service’s Web site at www.irs.gov. Computation of cost or other basis 5 6 7 8 9 1 0 11 12 1 3 1 4 Purchase price of property............................................................................................................... . Increases to basis: Improvements ............................................................................... 6. Closing costs ................................................................................ 7. Other ( explain ) 8. Add lines 6, 7, and 8 ......................................................................................................................... Add lines 5 and 9 .............................................................................................................................. Decreases to basis: Depreciation ( if applicable ) ............................................................. 11. 12. Other ( explain ) Add lines 11 and 12 .......................................................................................................................... Adjusted basis of property ( subtract line 13 from line 10 ) .................................................................... 5. 9. 10. 13. 14. Gain or loss 15 Sale price less selling expenses ( enter here and on the front page, Part 2, line 1 ) ............................................ 15. 1 6 Cost or adjusted basis ( from line 14 above ) .................................................................................................. 16. 1 7 Total gain or loss: Subtract line 16 from line 15. If the amount is a gain ( greater than zero), enter here, on the   front page, Part 2, line 2, and continue with line 18. If the amount is a loss ( less than or equal to zero), enter 0   here, on line 20 below, and on the front page, line 2. Complete Part 2, Part 3, and Form IT-2663-V on page 3. .... 17. Estimated tax due 1 8 Enter the gain from line 17 ( if only a portion of the gain from line 17 is subject to tax, see instructions below ) ...... 18. 1 9 New York State tax rate 8.82% ( .0882 ) ..................................................................................................... 19. . 2 0 Estimated tax due ( Multiply line 18 by line 19, and round to the nearest whole dollar; enter here and on the front page,   Part 2, line 3. Complete Form IT-2663-V, Nonresident Real Property Estimated Income Tax Payment Voucher, on page 3. )  20. .0882 00 Specific instructions for Worksheet for Part 2 Note: See Form IT‑2663-I, Instructions for Form IT‑2663, for complete instructions. Lines 5 through 17 — Multiple transferors/sellers: Enter the total purchase price, adjustments to basis, and sale price to determine the total gain (or loss) on the real property. See Line 18 below for allocation of the gain. Line 18 — Enter the gain (or portion of the gain) from line 17 that will be reported on your federal income tax return for 2012. • If only a portion of the property is located inside New York State, enter the gain allocated to the portion of the property located inside New York State. Attach a statement to Form IT-2663 showing how you computed the allocation. • If only a portion of the property qualifies as your principal residence, enter the gain allocated to the portion of the property that did not qualify as your principal residence and will be reported on your federal income tax return for 2012. Attach a statement to Form IT-2663 showing how you computed the allocation. • If two or more persons transfer or sell the real property, allocate the total gain on the property among the transferors/sellers in the same manner as the gain is allocated for federal income tax purposes. Attach a statement to Form IT-2663 showing each transferor’s/seller’s name, SSN or EIN, address, and share of the gain. • If the gain is being reported as an installment sale, enter the amount of gain that you (and your spouse, if applicable) will be reporting on your 2012 federal income tax return. • A nonresident estate or trust must enter the amount of the gain, without regard to any distributions, from line 17. Line 19 — When computing tax due on the gain from the transfer or sale of the real property, you must use the tax rate equal to the highest rate of tax for the tax year as set forth in the Tax Law section 601. For tax year 2012 that rate is 8.82% (.0882). Line 20 — This is the amount of your required estimated tax payment. Enter this amount on the front page, Part 2, line 3 and as your estimated tax payment on Form IT-2663-V on page 3. You must complete Form IT‑2663‑V, even if there is no payment of estimated personal income tax due. American LegalNet, Inc. www.FormsWorkFlow.com IT-2663 (2012)  Page 3 of 3 Note: You must complete Form IT‑2663‑V (below), even if there is no payment of estimated personal income tax due. This area is for county clerk use only. Attach check or money order here. You must attach a separate check or money order made payable to NYS Income Tax for the full amount of estimated personal income tax due as shown on Part 2, line 3, and Form IT‑2663-V (below). Do not detach IT-2663-V New York State Department of Taxation and Finance Nonresident Real Property Estimated Income Tax Payment Voucher For use on sale or transfer of real property by a nonresident Date fiscal year ends Enter date of conveyance and total payment in the boxes to the right. Print your name, social security number or employer identification number, and 2012 IT-2663-V on your payment. Make payable to NYS Income Tax. Date of conveyance Mark an X in one box: Identification number ( SSN or EIN of the estate or trust ) Individual Estate/trust Individual taxpayer’s full name or name of estate or trust Spouse’s name ( if applicable ) or name and title of fiduciary Spouse’s SSN Individual taxpayer’s street address or address of fiduciary or representative ( see instructions ) City, village, or post office State Dollars Cents 00 Total payment ZIP code 0431120094 American LegalNet, Inc. www.FormsWorkFlow.com