Form 40 - Individual Income Tax Return - 2005
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1
2Clear Form
•
Form
Amended Return
OREGON
40
For office use only
2005
INDIVIDUAL INCOME TAX RETURN
Fiscal year ending
Full-Year Residents Only
K
F
P
Q
R
Last name
(mm/dd/yyyy)
First name and initial
Date of birth
Social Security No. (SSN)
–
–
Deceased
(mm/dd/yyyy)
Spouse’s last name if joint return
Spouse’s SSN if joint return
Spouse’s first name and initial if joint return
Date of birth
–
–
Deceased
Current mailing address
Telephone number
(
)
City
State
Country
ZIP code
If you filed a return last year, and your
name or address is different, check here
•
Exemptions
Filing
Status
•
•
Total
1
Single
Check
2
Married filing jointly
6a Yourself......
Regular
........ Severely disabled
.........
6a
only
one
3
Married filing
6b Spouse ......
b
Regular
........ Severely disabled
...........
Spouse’s name
box
separately
•
6c All de pen dents
c
Spouse’s SSN
First names ________________________________
4
•
Head of household
6d Disabled
d
Person who qualifies you
First names ________________________________
children only
•
5
Qualifying widow(er) with dependent child
Total
6e
•
•
7a
•
•
Check
7b
You
7c
You
7d
You filed
You were:
65 or older
Blind
all that
filed an
filed federal
an Oregon
➛
apply
Spouse was:
65 or older
Blind
extension
Form 8886
Form 24
Round to the nearest dollar
8 Federal adjusted gross income. Federal Form 1040, line 37; 1040A, line 21;
•
.00
1040EZ, line 4; or 1040NR, line 35. See instructions, page 24 ...................................................................
8
•
.00
ADDITIONS
9 Interest and dividends on state and local government bonds outside of Oregon .....
9
•
•
$
10 Other additions. Identify:
10a
10b
.00
•
$
$
•
•
•
•
..........
10c
10d
10e
10f
10
•
.00
11 Total additions. Add lines 9 and 10...............................................................................................................
11
.00
•
12 Income after additions. Add lines 8 and 11 ..................................................................................................
12
.00
•
SUB TRAC TIONS
13 2005 federal tax liability ($0–$4,500; see instructions for the correct amount) ......
13
.00
•
14 Social Security included on federal Form 1040, line 20b; or Form 1040A, line 14b
14
•
.00
Staple
15 Oregon income tax refund included in federal income..............................................
15
W-2s,
.00
•
16 Interest from U.S. government, such as Series EE and HH bonds ..........................
16
payment,
•
.00
% .....
%
17 Federal pension income. See instructions, page 25.
17a
17b
17
and
payment
•
•
$
18 Other subtractions. Identify:
18a
18b
voucher
.00
$
$
•
•
•
•
•
..........
18c
18d
18e
18f
18
here
•
.00
19 Total subtractions. Add lines 13 through 18 .................................................................................................
19
.00
•
20 Income after subtractions. Line 12 minus line 19.........................................................................................
20
If you are claiming itemized deductions, fill in lines 21–25. If you are claiming the standard deduction, fill in line 26 only.
DEDUCTIONS
.00
•
21 Itemized deductions from federal Schedule A, line 28 ..............................................
21
•
.00
22 Special Oregon medical deduction (age restricted, see instructions, page 28) ........
22
.00
•
23 Total Oregon itemized deductions. Add lines 21 and 22 ...........................................
23
•
.00
24 State income tax or sales tax claimed as an itemized deduction.......................
24
.00
•
25 Net Oregon itemized deductions. Line 23 minus line 24 ..........................................
25
Either line 25 or 26
OR
•
.00
26 Standard deduction from page 28.............................................................................
26
.00
•
27 Total deductions. Line 25 or line 26, whichever is larger .........................................................................
27
•
.00
28 Oregon taxable income. Line 20 minus line 27. If line 27 is more than line 20, fill in -0- ....................................
28
•
.00
TAX
29 Tax. See instructions, page 29. Enter tax here .........................................................
29
•
•
Check if tax is from:
Form FIA-40 or
Worksheet FCG
.00
•
30 Interest on certain installment sales..........................................................................
30
•
.00
31 Total tax. Add lines 29 and 30 .............................................................................................
OREGON TAX
31
➛
NOW GO TO THE BACK OF THE FORM
150-101-040 (Rev. 12-05) Web
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