Form 2a - Fillable 2004
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3Questions? Please call (406) 444-6900 or TDD (406) 444-2830
Form 2A
MONTANA
Page 1
2004
Last Name and Initial
Social Security Number
Column A (For
Column B (For
single, joint,
spouse only when
Schedule I — Itemized Deductions
separate or head
filing separate, and
of household)
box 3 is checked)
70.
70.
Medical insurance premiums not deducted on lines 19, 35 or 74.....70.
Do not include pre-tax payroll deductions or employer paid premiums.
Column A
Column B
Round to nearest dollar
71.
Medical expenses. See instructions.................
71.
72.
Enter 7.5% (.075) of line 38, Form 2..........
72.
73.
Subtract line 72 from line 71. If less than zero, enter zero.
73.
Deductible medical and dental expenses........................................... 73.
74.
74.
Long term care insurance.......................................................................... 74.
Federal Income Tax (Amounts attributable
to self employment tax are not deductible)
Column A
Column B
75.
2004 federal tax withheld from wages, pensions
75.
and annuities. Attach W-2's and 1099's.........
76. Federal estimated tax payments made in 2004.
Attach copies of pages 1 and 2 of federal
76.
tax return (Form 1040 or 1040A)...................
77.
77.
Balance of 2003 tax paid in 2004..................
78.
78.
Additional federal tax for year(s) paid in 2004.
79.
79. Total 2004 federal tax deduction - add lines 75, 76, 77, and 78 ....
79.
80.
80. Real estate personal property taxes...................................................
80.
81.
81.
Motor vehicle(s) taxes, other deductible taxes...................................
81.
82.
Home mortgage interest____________ Deductible points______
If paid to the person from whom you bought the home, please provide
person's name, address and social security #________________
82.
82.
83.
83.
Deductible investment interest ...............Attach Federal Form 4952
83.
84.
84.
Contributions ....................................................................................
84.
85.
85.
Child and dependent care expense ...Attach Montana Form 2441M 85.
86.
86.
Casualty and theft losses........................Attach Federal Form 4684
86.
87.
Unreimbursed employee business expense
Column A
Column B
Attach Federal Form 2106................................87.
88.
Other expenses (list type and amount)____
88.
__________________________________
89.
Add lines 87 and 88..........................................
89.
90.
Enter 2% (.02) of line 38 Form 2.....................
90.
91.
Subtract line 90 from 89. If less than zero,
91.
enter zero..................................................................................................... 91.
92.
Misc. deduction not subject to 2% A.G.I. (list type and amount)
92.
___________________________________________________ 92.
93.
93. Gambling losses (as allowed by federal law)..................................... 93.
94a.
94a. Add lines 70, 73, 74, 79-86, 91-93. Enter result here.................Total
94a.
If the amount on Form 2, line 38 is more than $142,700
(more than $71,350 if you are married filing separately)
continue to line 94b, otherwise transfer the amount on
line 94a to line 39 of Form 2.
94b. Enter the amount from line 9 of the Itemized Deduction
Worksheet VI on page 14. This is the amount of your unallowable
94b.
itemized deductions................................................................................... 94b.
95.
Subtract line 94b from line 94a. This is the amount of your
allowable itemized deductions. Enter here and on
95.
line 39 of Form 2...............................................................................Total 95.
When you file your Montana income tax return electronically you represent that you have retained all
documents required as a tax record and that you will provide a copy to the department upon request.
101
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