Form 511x - Oklahoma Amended Resident Individual Income Tax Return - 2010 Page 3

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Form 511X (B) - Page 2

As Originally

Office Use Only

Reported or as

Amended

Previously Adjusted

16 Enter total tax from line 15E ..........................................

17 Use Tax .........................................................................

18 Business Activity Tax (Beginning with Tax Year 2010) ..

19 Total Tax: Add lines 16, 17 and 18. Enter total here ......

Payments...

20 Oklahoma income tax withheld .....................................

21 Oklahoma estimated tax paid plus amount paid

with extension ...............................................................

22 Amount paid with original return plus additional paid

after it was filed .............................................................

23 Refundable credits (see instructions) ............................

24 Total of lines 20 through 23 ...........................................

Refund or Amount You Owe...

25 Overpayment, if any, as shown on original return or as previously adjusted

by Oklahoma (see instructions) ....................................................................

26 Subtract line 25 from line 24 .........................................................................

27 Refund: If line 26 is more than line 19 enter difference ................................

28 Tax liability: If line 19 is more than line 26 enter difference ...........................

29 Interest: 1.25% per month from _______________ to ________________

30 Total amount due (add lines 28 and 29).Please pay in full with this return .

If you are changing your Oklahoma return due to a change to your

STOP

Federal return, enclose proof that the IRS approved the change.

Explain below or attach a separate schedule, if necessary, explaining the

Please check here if the Oklahoma Tax

changes to income, deductions, and/or credits: (Enter the line reference number

Commission may discuss this return with

for which you are reporting a change and give the reason for each change in column “B”)

your tax preparer.

The Oklahoma Tax Commission is not required to give actual notice to taxpayers of changes in any state tax law.

Remit to: Oklahoma Tax Commission, P.O. Box 26800, Oklahoma City, Oklahoma 73126-0800

Under penalties of perjury, I declare that I have filed an original return and that I have examined this return including accompanying schedules and statements, and to the best of my knowledge this

amended return is true, correct and complete.

Declaration of preparer (other than taxpayer) is based on all information of which the preparer has any knowledge.

Taxpayer signature

Date

Preparer’s signature

Date

Preparer’s printed name

Spouse’s signature (if filing jointly both must sign)

Date

Preparer’s Address

Daytime Phone Number (optional)

(