Form Il-1040-X - Amended Individual Income Tax Return - 2010
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Illinois Department of Revenue
2010 Form IL-1040-X
Amended Individual Income Tax Return
REV 11
Step 1: Personal information
Do not write above this line.
A
Print or type your current Social Security number(s), name(s), and address.
–
–
–
–
Your Social Security number
Spouse’s Social Security number
Your fi rst name and initial
Spouse’s fi rst name and initial (and last name - only if different)
Your last name
Mailing address
Apt. number
City
State
ZIP or Postal Code
Foreign Nation, if not U.S.A.
B
If your Social Security number(s), name(s), or address listed above are different from your previously fi led return, check the box.
C
Filing Status:
Single or head of household
Married fi ling jointly
Married fi ling separately
Widowed
D
Residency:
Resident
Nonresident
Part-year resident
E
**
Check the box that identifi es why you are making this change.
Attach a copy of your federal fi nalization. (see instructions)
____ ___ ____
____ ____ ____
**
**
Federal change accepted on
NOL accepted on
State change
Month
Day
Year
Month
Day
Year
Step 2: Reason for fi ling
If you are changing your Illinois return due to a change to your federal return that resulted in an overpayment, do not fi le this form
until you receive notifi cation that the Internal Revenue Service (IRS) has accepted the changes. See ‘‘How long do I have to correct or
amend my return?’’ in the instructions.
______/______/______
F
On what date did you fi le your original Form IL-1040 or your latest Form IL-1040-X?
G
Did you fi le a U.S. Form 1040X? If "yes," you must attach a copy to this form.
yes
no
If your U.S. Form 1040X resulted in
an overpayment, you must also attach a copy of the notifi cation you received from the Internal Revenue Service (IRS) stating they
accepted the changes shown on your U.S. Form 1040X (e.g., a refund check, "Statement of Account," agreement, or judgment),
and write the date the IRS notifi ed you (not the date you fi led your U.S. 1040X) in the appropriate space in Step 1, Line E.
an amount due, write the date you fi led your U.S. Form 1040X and paid the tax due in the appropriate space in Step 1, Line E.
Failure to provide this date could result in an assessment of a late-payment penalty.
H
Explain, in detail, the reason(s) for fi ling this amended return. Attach a separate sheet if necessary.
Step 3: Financial information
Corrected Figures
(Line numbers may not match your original return.)
1
1
Federal adjusted gross income
.00
2
2
Federally tax-exempt interest and dividend income
.00
3
3
Other additions (attach Schedule M with amended fi gures)
.00
4
4
Total income. Add Lines 1 through 3.
.00
5
5
Federally taxed Social Security and federally taxed retirement plan income
.00
6
6
Illinois Income Tax overpayment included in U.S. 1040, Line 10 (attach U.S. 1040, page 1)
.00
7
7
Other subtractions (attach Schedule M with amended fi gures)
.00
8
8
Total subtractions. Add Lines 5 through 7.
.00
9
9
Illinois base income. Subtract Line 8 from Line 4.
.00
10
a
10a
Number of exemptions:
yourself and your dependents
X $2000
.00
(as corrected)
b
10b
65 years or older or legally blind
X $1000
.00
(as corrected)
c
10c
Add Lines 10a and 10b. This is your exemption allowance.
.00
11
11
Residents only: Net income. Subtract Line 10c from Line 9.
.00
12
Nonresidents and part-year residents only: Write your Illinois base
12
income from Schedule NR. (attach Schedule NR with amended fi gures)
.00
13
Residents: Multiply Line 11 by 3% (.03).
13
Nonresidents and part-year residents: Write the tax before recapture of investment credits from Schedule NR.
.00
14
14
Recapture of investment tax credits (attach Schedule 4255)
.00
15
15
Total tax. Add Lines 13 and 14.
.00
Offi cial Use
*061501110*
IL-1040-X (R-12/10)
Page 1 of 4
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