Form PIT-S Supplemental Schedule For Dependent Exemptions in Excess of Five

*120260200* 16 9 10 11 12 13 14 15 8 17 18 19 20 Name First name Last name Column 1 7 6 Dependent's Social security number Column 2 Line 8 Form 2012 PIT 1 DEPENDENTS continued Enter the names as listed on the federal form Date of birth (MM/DD/YYYY) Column 3 / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 2012 PIT S If you need additional space attach multiple Schedules PIT S NEW MEXICO SUPPLEMENTAL SCHEDULE FOR DEPENDENT EXEMPTIONS IN EXCESS OF FIVE Print your name (first middle last) Schedule PIT S must be attached to Form PIT 1 or your additional exemptions will be denied Use Schedule PIT S ONLY if you have more than five federal qualifying dependent exemptions If you have more than five federal dependent exemptions enter the name social security number and date of birth of the first five qualify ing dependents on line 8 of 2012 Form PIT 1 Enter the name social security number and date of birth of the remaining qualifying dependents on 2012 Schedule PIT S and attach the Schedule PIT S to your 2012 New Mexico Personal Income Tax Return Enter only qualifying dependent exemptions allowed on your federal return Do not include yourself or your spouse if filing a joint return New Mexico uses the same definitions and qualifications as the Internal Revenue Service to determine if someone is a qualified dependent See the instructions for Federal Form 1040 1040A or 1040EZ to determine who you may claim as a dependent exemption or visit the IRS website at www irs gov YOUR SOCIAL SECURITY NUMbER