Form 1 Draft - Wisconsin Income Tax - 2015 Page 3
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1
2
3
42015
3 of 4
Form 1
Page
Name(s) shown on Form 1
Your social security number
NO COMMAS; NO CENTS
.00
39 Amount from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
.00
40 Wisconsin tax withheld . Enclose withholding statements . . . . . 40
41 2015 estimated tax payments and amount
applied from 2014 return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
.00
42 Earned income credit . Number of qualifying children . .
Federal
.00
.00
credit . . . .
x
% = . . . . . . . . . 42
43 Farmland preservation credit . a Schedule FC, line 18 . . . . . . . 43a
.00
b Schedule FC‑A, line 13 . . . . . 43b
.00
.00
44 Repayment credit (see page 42) . . . . . . . . . . . . . . . . . . . . . . . . 44
.00
45 Homestead credit . Enclose Schedule H or H‑EZ . . . . . . . . . . . . 45
.00
46 Eligible veterans and surviving spouses property tax credit . . . 46
.00
47 Other credits from Schedule CR, line 38 .
47
Enclose Schedule CR
.00
48 AMENDED RETURN ONLY – Amounts previously paid
48
(see page 44)
.00
49 Add lines 40 through 48 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
50 AMENDED RETURN ONLY – Amounts previously refunded
50
.00
(see page 44)
.00
51 Subtract line 50 from line 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
52 If line 51 is larger than line 39, subtract line 39 from line 51 .
.00
This is the AMOUNT YOU OVERPAID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
.00
53 Amount of line 52 you want REFUNDED TO YOU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
54 Amount of line 52 you want
.00
APPLIED TO YOUR 2016 ESTIMATED TAX . . . . . . . . . . . . . . 54
55 If line 51 is smaller than line 39, subtract line 51 from line 39 . This is the
.00
AMOUNT YOU OWE . Paper clip payment to front of return . . . . . . . . . . . . . . . . . . . . . . . . . . 55
56 Underpayment interest . Fill in
56
exception code ‑ See Sch . U
.00
Also include on line 55 (see page 46)
Third
Yes
No
Do you want to allow another person to discuss this return with the department
(see page 47)
?
Complete the following .
Party
Personal
Designee’s
Phone
identification
Designee
(
)
name
no .
number (PIN)
Paper clip copies of your federal income tax return and schedules to this return.
Assemble your return (pages 1-4) and withholding statements in the order listed on page 6.
Sign here
Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.
Your signature
Spouse’s signature (if filing jointly, BOTH must sign)
Date
Daytime phone
(
)
I‑010ai
Mail your return to:
Wisconsin Department of Revenue
If tax due .....................................PO Box 268, Madison WI 53790‑0001
If refund or no tax due . . . . . . . . . . . . . . . . .PO Box 59, Madison WI 53785‑0001
If homestead credit claimed . . . . . . . .PO Box 34, Madison WI 53786‑0001
Do Not Submit Photocopies
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