Form Ia 1040 - Iowa Individual Income Tax Return Form - 2016 Page 2

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2016 IA 1040,
page 2
B. Spouse/Status 3
A. You or Joint
B. Spouse/Status 3
A. You or Joint
Step 8
BALANCE. From side 1, line 35...................................................................................................................................... 36.
36.
.00
.00
Taxable
37.
Deduction. Check one box ▲
Itemized.(Include IA Schedule A)
Standard
...............................................
Income
37.
.00
.00
38.
TAXABLE INCOME. SUBTRACT line 37 from line 36 ................................................................................................... 38.
________________________________
.00
_____________________________
.00
Step 9
Tax from tables or alternate tax ................................................................ 39.
39.
.00
.00
Tax,
Credits,
Iowa lump-sum tax. 25% of federal tax from form 4972 ................................
40.
40.
.00
.00
and
Check-
Iowa alternative minimum tax. Include IA 6251. ..............................................
41.
41.
.00
.00
off
42.
Total tax. ADD lines 39, 40, and 41. ............................................................................................................................... 42.
Contribu
.00
.00
-tions
43.
Total exemption credit amount(s) from Step 3, side 1. ................................
43.
.00
.00
44.
Tuition and textbook credit for dependents K-12. ............................................
44.
.00
.00
Volunteer firefighter/EMS/reserve peace officer credit. ................................
45.
45.
.00
.00
Total credits. ADD lines 43, 44, and 45. ............................................................................................................................ 46.
46.
.00
.00
47.
BALANCE. SUBTRACT line 46 from line 42. If less than zero, enter zero. ...................................................................... 47.
.00
.00
48.
Credit for nonresident or part-year resident. Include IA 126 and federal return. ............................................................... 48.
.00
.00
49.
BALANCE. SUBTRACT line 48 from 47. If less than zero, enter zero. ............................................................................. 49.
.00
.00
Out-of-state tax credit. Include IA 130. .............................................................................................................................. 50.
50.
.00
.00
BALANCE. SUBTRACT line 50 from 49. If less than zero, enter zero. ............................................................................. 51.
51.
.00
.00
Other nonrefundable Iowa credits. Include IA 148 Tax Credits Schedule......................................................................... 52.
52.
.00
.00
53.
BALANCE. SUBTRACT line 52 from line 51. If less than zero, enter zero. ...................................................................... 53.
.00
.00
54.
School district surtax or EMS surtax. Take percentage from table; multiply by line 53..................................................... 54.
.00
.00
Total state and local tax. ADD lines 53 and 54. ................................................................................................................. 55.
55.
.00
.00
TOTAL state and local tax before contributions. Combine columns A and B on line 55 and enter here. .............................................................. 56
56.
.
.00
Contributions will reduce your refund or add to the amount you owe. Amounts must be in whole dollars.
57.
57.
Fish/Wildlife 57a:
State Fair 57b:
Firefighters/Veterans 57c:
Child abuse Prevention 57d:
Enter here............
.00
58.
TOTAL STATE AND LOCAL TAX, AND CONTRIBUTIONS. Add line 56 and line 57 and enter here................................................................. 58. ▲
_____________________________
.00
Step 10
Iowa Fuel tax credit. Include IA 4136 ...............................................................
59.
59.
.00
.00
Credits
Check One:
Child and dependent care credit
OR
60.
▲ Early childhood development credit
60.
.00
.00
Iowa earned income tax credit. 15.0% (.15) of federal credit ..........................
61.
61.
.00
.00
Other refundable credits. Include IA 148 Tax Credits Schedule......................
62.
62.
.00
.00
Total refundable Iowa credits. ADD lines 59 - 62. ...........................................
63.
63.
.00
.00
0
0
RESERVED FOR FUTURE USE ................................................................
64.
64.
.00
.00
0
0
Taxpayers trust fund tax credit. The credit for 2016 is $0................................
65.
65.
.00
.00
Iowa income tax withheld. ................................................................................
66.
66.
.00
.00
Estimated and voucher payments made for tax year 2016. ............................
67.
67.
.00
.00
TOTAL. ADD lines 63, 65, 66, and 67..............................................................
68.
68.
.00
.00
TOTAL CREDITS. ADD columns A and B on line 68 and enter here ....................................................................................................................
69.
69.
_____________________________
.00
Step 11
If line 69 is more than line 58, Subtract line 58 from line 69. This is the amount you overpaid. ............................................................................
70.
70.
.00
Refund
or
Amount of line 70 to be REFUNDED. ..............................................................................................................................................REFUND
71.
71.
.00
Amount
For a faster refund file electronically. Go to https://tax.iowa.gov for details
Due
Amount of line 70 to be applied to your 2017 estimated tax....................
72.
72.
.00
.00
If line 69 is less than line 58, Subtract line 69 from line 58. This is the AMOUNT OF TAX YOU OWE ................................................................
73.
73.
.00
Penalty for underpayment of estimated tax from IA 2210, IA 2210S, or IA 2210F. Check if annualized income method is used. ▲
74.
74.
.00
Penalty and interest
ADD. Enter total..........
75.
▲ 75a.Penalty
.00
▲ 75b. Interest
.00
75.
.00
TOTAL AMOUNT DUE. ADD lines 73, 74, and 75. Enter here..................................................................................... PAY THIS AMOUNT
76.
76.
.00
Step 12
.
$1.50 to Republican Party
$1.50 to Republican Party
Political Checkoff - This checkoff does not
increase the amount of tax you owe or
$1.50 to Democratic Party
$1.50 to Democratic Party
▲Spouse
▲Yourself
decrease your refund.
$1.50 to Campaign Fund
$1.50 to Campaign Fund
Step 13
I (We), the undersigned, declare under penalty of perjury that I (we) have examined this return, including all accompanying schedules and statements, and, to the best of my
(our) knowledge and belief, it is a true, correct, and complete return. Declaration of preparer (other than taxpayer) is based on all information of which the preparer has any
knowledge.
SIGN
HERE
Your Signature
Date
Check if Deceased
Date of Death
Preparer's Signature
Date
SIGN
HERE
Spouse's Signature
Date
Check if Deceased
Date of Death
Preparer's PTIN
Firm's FEIN
Daytime Telephone Number
Daytime Telephone Number
This return is due May 1, 2017. Please sign, enclose W-2s, and verify SSNs.
You can pay online at https://tax.iowa.gov/
Make check payable to Treasurer, State of Iowa.
MAILING ADDRESS: Iowa Income Tax Document Processing,
PO BOX 9187, Des Moines IA 50306-9187.
41-001 (05/13/16)

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