Form 1040n Draft - Nebraska Schedule I - Nebraska Adjustments To Income

FORM 1040N

Schedule III

Nebraska Schedule III

— Computation of Nebraska Tax

2014

Name on Form 1040N

Social Security Number

Nebraska Schedule III —

Computation of Nebraska Tax for PARTIAL-YEAR RESIDENTS AND NONRESIDENTS ONLY

• You must complete lines 1 through 14, Form 1040N. If you have state, local, or federal bond interest or other

adjustments, complete Parts A and B of Nebraska Schedule I. Use Schedule III to calculate your Nebraska tax liability.

• You do not have to provide a copy of other state returns when filing Schedule III.

77 Income derived from Nebraska sources. Include income from wages, interest, dividends, business, farming,

Nebraska unemployment payments, severance payments connected to Nebraska employment, partnerships,

S corporations, limited liability companies, estates and trusts, gain or loss, rents, royalties, and financial institution

tax credit amount. If there is no Nebraska income or loss, enter -0-.

a List type:

b Amount: $

List type:

Amount:

Total income derived from Nebraska sources. Enter total of lines 77b ............................................................ 77

78 Adjustments as applied to Nebraska income, if any (see instructions)

a List type:

b Amount: $

List type:

Amount:

Total adjustment as applied to Nebraska income. Enter total of lines 78b ...................................................... 78

79 Nebraska adjusted gross income (line 77 minus line 78) ................................................................................... 79

80 R atio — Nebraska’s share of the total income (calculate to six decimal places, and round to five):

Line 79

Line 5 + Line 12 - Line 13

81 Nebraska Taxable Income (line 14, Form 1040N) ............................................................................................... 81

82 Nebraska tax calculation (see instructions)

a Tax on Nebraska taxable income from line 81 ............................................................82 a $ ___________

b Additional tax, if applicable, from Additional Tax Rate Schedule .................................82 b $ ___________

c Subtotal tax (add lines 82a and line 82b) ....................................................................82 c $ ___________

d Partial-year residents, enter Nebraska nonrefundable credit for the elderly or disabled . 82 d $ ___________

e Partial-year residents, enter Nebraska child/dependent care nonrefundable credit ....82 e $ ___________

f Subtotal credits (add lines 82d and 82e) .....................................................................82 f $ ___________

Line 82c minus line 82f ...................................................................................................................... ............ 82

83 Multiply personal exemption credit of $128 by the number of federal exemptions on line 4 ............................... 83

84 Tax after personal exemption credit (line 82 minus line 83). If less than $0, enter -0- here, and if you have

any other tax due, apply any unused personal exemption credit against it on line 86e ...................................... 84

85 Nebraska income tax. Multiply line 84 by the ratio you computed on line 80. Enter result here and on

line 15, Form 1040N ............................................................................................................................................ 85

86 Nebraska other tax calculation:

a Federal Tax on Lump Sum Distributions (Form 4972) .................................................86 a $ ___________

b Federal tax on early distributions (lesser of Form 5329 or line 58, Fed. Form 1040) ...86 b $ ___________

c Subtotal (add lines 86a and 86b) .................................................................................86 c $ ___________

d Tax calculation. Multiply line 86c by 29.6% (x .296) ....................................................86 d $ ___________

e Enter any unused personal exemption credit from the calculation on line 84 ..............86 e $ ___________

f Subtract line 86e from line 86d ....................................................................................86 f $ ___________

Multiply line 86f by line 80 ratio. Enter result here and on line 16, Form 1040N. .......................................... 86

87 Earned income credit (Partial-Year Residents Only)

a Number of qualifying children. Enter here and on line 33, box 97, Form 1040N .........87 a ____________

b Enter federal earned income credit from federal tax return here and on

line 33, box 98, Form 1040N ......................................................................................87 b $ ___________

Multiply line 87b amount by 10% (x .10). Enter the result here. (see instructions) ......................................... 87

88 Nebraska earned income credit. Multiply line 87 by the ratio you computed on line 80 (attach federal tax

return pages 1 and 2 to your return). Enter result here and on line 33, Form 1040N .......................................... 88

Form 1040n Draft - Nebraska Schedule I - Nebraska Adjustments To Income - 2014 Page 3

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