N SIGNATURE, ON THIS FORM EFTA00792046 Page 4 of 4 IT-201 (2017) Your social security umber 765004 11.17.17 62 Enter amount from line 61 816 IPayments and refundable credltel (see pages 28 through 31) 63 64 65 66 67 Empire State child credit NYS/NYC child and dependent care credit 63 .00