Form 40 - 2005 Individual Income Tax Return Page 2
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1
2Form 40 (2005)
Page 2
1
Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
00
PART I
2
Business income or (loss) (attach Federal Schedule C or C-EZ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
00
Gain or (loss) from sale of Real Estate, Stocks, Bonds, etc. (attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3
00
00
4a Total IRA distributions
4a
4b Taxable amount (see instructions) . . . . . . . . . . . . . . .
4b
00
00
5a Total pensions and annuities
5a
5b Taxable amount (see instructions) . . . . . . . . . . . . . . .
5b
00
Other
6
Rents, royalties, partnerships, estates, trusts, etc. (attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
00
Income
7
Farm income or (loss) (attach Federal Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
00
(see page 13)
8
Other income (state nature and source — see instructions)
8
00
Return to Page 1
9
Total other income. Add lines 1 through 8. Enter here and also on page 1, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
00
1a Your IRA deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1a
00
PART II
1b
00
b Spouse’s IRA deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Payments to a Keogh retirement plan and self-employment SEP deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
00
3
00
3
Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Adjustments
4
Alimony paid. Recipient’s last name
Social security no.
to Income
Address
City
State
ZIP
4
00
(see page 16)
5
00
5
Adoption expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Moving Expenses (Attach Federal Form 3903) to City
State
ZIP
6
00
7
00
7
Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Return to Page 1
8
00
8
Total adjustments. Add lines 1 through 7. Enter here and also on page 1, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PART III
(4) Did you provide
Dependents:
(2) Dependent’s social security
1a
(3) Dependent’s
more than one-half
(1) First name
Last name
number.
relationship to you.
dependent's support?
Dependents
Do not include
yourself or
your spouse
b Total number of dependents claimed above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Amount allowed. (Multiply $300 by the total number of dependents claimed on line 1b.)
(See page 9)
Return to Page 1
00
2
PART IV
Residency
Full Year
1
If you were a part-year resident of Alabama during 2005, indicate your period of residence:
Part Year
Check only one box
From
2005 through
2005. Total months
2
Did you file an Alabama income tax return for the year 2004?
Yes
No
3
If no, state reason.
General
4
Give name and address of present employer(s). Yours
Information
Your Spouse’s
5
Enter the Federal Adjusted Gross Income $
and Federal Taxable Income $
as reported on your 2005
All Taxpayers
Federal Individual Income Tax Return.
Must Complete
6
Do you have income which is reported on your Federal return, but not reported on your Alabama return (other than your state tax refund)?
Yes
No
This Section.
If yes, enter source(s) and amount(s) below: (other than state income tax refund)
00
Source
Amount
00
Source
Amount
PART V
For Direct Deposit of your refund, complete 1, 2, and 3 below. (See Page 17 of instructions to see if you qualify.)
1
Routing Number:
2 Type:
Checking
Savings
Direct Deposit
3
Account Number:
I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
Sign Here
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,
In Black Ink
they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature
Date
Daytime telephone number
Your occupation
Keep a copy
(
)
of this return
for your records.
Spouse’s signature (if joint return, BOTH must sign)
Date
Daytime telephone number
Spouse’s occupation
(
)
Date
Preparer’s SSN or PTIN
Check if
Paid
Preparer’s
self-employed
signature
Preparer’s
Firm’s name (or yours
Daytime telephone no. (
)
E.I. No.
Use Only
if self-employed)
and address
ZIP Code
If an addressed envelope came with your return, please use it and follow the instructions on the envelope. If you do not have one, mail your return to one of the
addresses below.
WHERE TO
If you are not making a payment, mail your return to:
If you are making a payment, mail your return, Form 40V, and payment to:
Alabama Department of Revenue
Alabama Department of Revenue
FILE
P. O. Box 154
P. O. Box 2401
FORM 40
Montgomery, AL 36135-0001
Montgomery, AL 36140-0001
Mail only your 2005 Form 40 to one of the above addresses. Prior year returns, amended returns, and all other correspondence should be mailed to
Alabama Department of Revenue, P.O. Box 327464, Montgomery, AL 36132-7464.
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