Form 40a - Alabama Department Of Revenue - Individual Income Tax Return - 2016

FORM

1600014A

40A

2016

Alabama Individual Income Tax Return

FULL YEAR RESIDENTS ONLY

•

Your social security number

For the year Jan. 1 - Dec. 31, 2016, or other tax year:

Beginning:

Ending:

•

Your first name

Initial

Last name

•

Check if primary is deceased

•

Primary’s deceased date (mm/dd/yy)

•

Spouse’s first name

Initial

Last name

•

Spouse’s social security number

•

Present home address (number and street or P.O. Box number)

•

•

Check if spouse is deceased

City, town or post office

State

ZIP code

Spouse’s deceased date (mm/dd/yy)

•

•

Foreign Country

Check if address

•

is outside U.S.

•

CHECK BOX IF AMENDED RETURN

•

•

Filing Status/

1

$1,500 Single

3

$1,500 Married filing separate. Complete Spouse SSN

Exemptions

•

•

2

$3,000 Married filing joint

4

$3,000 Head of Family (with qualifying person).

5a

Alabama Income Tax Withheld (from Schedule W-2, line 18, column G) . . . . . . . . . . . . . . . . . . . . . . . . . . .

A — Alabama tax withheld

B — Income

Income

•

•

00

00

5b

Wages, salaries, tips, etc. (from Schedule W-2, line 18, column I plus J). . . . . . . . . . . . . . . . . . . . . . . . . . .

5a

5b

and

•

00

6

6

Interest and dividend income. If over $1,500.00, use Form 40. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Adjustments

•

00

7

7

Total income. Add lines 5 and 6 (column B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

Deductions

00

8

8

Standard Deduction (enter amount from table on page 9 of instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . .

You Must Attach page

9

Federal tax deduction (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 of Federal Form

•

00

DO NOT ENTER THE FEDERAL TAX WITHHELD FROM YOUR FORM W-2(S)

9

1040, Federal Form

1040A, Federal Form

•

00

10

10

Personal exemption (from line 1, 2, 3, or 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1040NR, or page 1 of

Form 1040EZ, if claim-

•

00

11

Dependent exemptions (from page 2, Part II, line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11

ing a deduction on line

•

00

9.

12

12

Total deductions. Add lines 8, 9, 10, and 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

13

13

Taxable income. Subtract line 12 from line 7. Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

14

Find the tax for the amount on line 13. Use the tax table in the Instruction Booklet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14

•

00

15

15

Consumer Use Tax (see instructions). If you certify that no use tax is due, check box

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

16a

16

You may make a voluntary contribution to: a Alabama Democratic Party . . . . . . . .

$1

$2

none . . . . . . . . . . . . . . . . . . . .

Tax and

•

00

16b

b Alabama Republican Party . . . . . . . . .

$1

$2

none . . . . . . . . . . . . . . . . . . . .

Payments

•

00

17

17

Total tax liability and voluntary contribution. Add lines 14, 15, 16a, and 16b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Staple Form(s) W-2,

•

00

18

Alabama income tax withheld (from column A, line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18

W-2G, and/or 1099

•

00

19

19

Automatic Extension Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

here.

•

00

20

20

Amended Returns Only — Previous payments (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

21

21

Total payments. Add lines 18, 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

22

22

Amended Returns Only – Previous refund (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

23

Adjusted Total Payments. Subtract line 22 from line 21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23

AMOUNT

24

If line 17 is larger than line 23, subtract line 23 from line 17, and enter AMOUNT YOU OWE.

YOU OWE

•

00

Place payment, along with Form 40V, loose in the mailing envelope. (FORM 40V MUST ACCOMPANY PAYMENT.)

24

•

OVERPAID

00

25

25

If line 23 is larger than line 17, subtract line 17 from line 23 and enter amount OVERPAID. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Donations

•

00

26

26

Total Donation Check-offs from page 2, Part IV, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27

REFUNDED TO YOU. Subtract line 26 from line 25.

REFUND

•

00

27

(You MUST SIGN this return before your refund can be processed.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

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, they are

In Black Ink

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

Preparer’s

Check if

Paid

•

signature

self-employed

Preparer’s

Firm’s name (or yours

Daytime telephone no. (

)

E.I. No.

Use Only

if self-employed)

ZIP Code

and address

ADOR