Form Nj-1040ez - State Of New Jersey Income Tax-Resident Return - 2003
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1
2STATE OF NEW JERSEY INCOME TAX-RESIDENT RETURN
NJ-1040EZ
Fill in
if application for Federal extension is enclosed
Round down all amounts less than 50 cents. Round up all amounts of 50 through 99 cents.
2003
DO NOT ENTER CENTS.
or enter confirmation #_________________________________
5R
IMPORTANT! YOU MUST ENTER YOUR SSN (s).
,
13. Wages, Salaries, Tips, etc. (Enclose W-2)............
13
-
-
Your Social Security Number
,
14a. Taxable Interest Income ........................................
14a
-
-
Spouse’s Social Security Number
,
14b
14b. Tax-Exempt Interest Income...
County/Municipality Code
Do NOT include on Line 14a
(See Table page 31)
,
15
15. Dividends ...............................................................
Place label on form if all preprinted information is correct. Otherwise, print or type your name and address.
Last Name, First Name and Initial
(Joint filers enter first name and initial of each. Enter spouse last name ONLY if different)
,
16
16. NJ Gross Income (Add Lines 13, 14a, and 15).....
(See instructions)
,
17
17. Total Exemption Amount (From Line 12e) ............
Home Address (Number and Street, including apartment number or rural route)
,
18
18. Medical Expenses (See instructions) ....................
,
City, Town, Post Office
State
Zip Code
19
19. Taxable Income (Line 16 minus Lines 17 and 18)
,
20
20. Property Tax Deduction (See instructions) ...........
FILING STATUS (Fill in only one)
,
21
21. NEW JERSEY TAXABLE INCOME ......................
1.
Single
(Line 19 minus Line 20)
,
2.
Married, filing joint return
22
22. Tax (From Tax Table, page 33) ............................
3. Married, filing separate return - must file Form NJ-1040
,
23
23. Use Tax Due on Out-of-State Purchases..............
4.
Head of household
If no Use Tax, enter a ZERO (0)
,
5.
Qualifying widow(er)
24
24. Total Tax (Add Line 22 and Line 23).....................
EXEMPTIONS
,
25
25. NJ Income Tax Withheld (Enclose W-2) ...............
6
6. Regular
Yourself
Spouse .............
ENTER
26
7
NUMBERS
26. Property Tax Credit (See instructions) ..................
7. Age 65 or Over
Yourself
Spouse .............
HERE
,
8
27
27. Estimated Payments/Credit from 2002 return .......
8. Blind or Disabled
Yourself
Spouse .............
Fill in
if Form NJ-2210 enclosed
9
28
28. New Jersey Earned Income Tax Credit .............
9. Number of your qualified dependent children.....................
Complete schedule on Page 2
10
,
10. Number of other dependents ..............................................
29
29. Total Payments and Credits (Add Lines 25 - 28) ..
11
,
11. Dependents attending colleges ..............................
30
30. AMOUNT OF TAX YOU OWE
.....
(See instructions)
12a
12b
12. Totals
(For Line 12a - Add Lines 6, 7, 8, and 11)
Fill in
if paying by e-check or credit card.
,
(For Line 12b - Add Lines 9 and 10)
31
31. OVERPAYMENT ...................................................
(See instructions)
Exemptions:
12c.. . . . . . . Line 12a______x $1,000 = ____________
,
32
32. Total Deductions From Overpayment
...................
12d. . . . . . . Line 12b______x $1,500 = ____________
(From Page 2, Line 8)
,
33
33. REFUND (Line 31 minus Line
32).........................
12e. Total Exemption Amount. . . . . . . ____________
Add Lines 12c and 12d. Enter result here and on Line 17.
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