Form 40p - Oregon Individual Income Tax Return For Part-Year Residents - 2012

ADVERTISEMENT

1
1
2
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
4
4
5
5
5
5
5
5
5
5
5
5
6
6
6
6
6
6
6
6
6
6
7
7
7
7
7
7
7
7
7
7
8
8
2
8
8
8
Paper
2-D with header only
2-D with grid & data
1
2
3
5
6 7 8 9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
3
4
5
4
82
3
3
2012
For office use only
Amended return
OREGON
4
4
Amended Return
2012
OREGON INDIVIDUAL INCOME TAX RETURN
Form
5
5
Form
40P
40P
For Part-Year Residents
For office use only
Individual Income Tax Return
6
Fiscal year ending
6
f r o m
X X / X X / X X X X
T o
X X / X X / X X X X
K
F
P
J
7
7
FOR PART-YEAR RESIDENTS
P S S N X X - X X X X
S S S N X X - X X X X
8
8
P l a S T N a m e X X X X X X X X X X X P f i r S T N a m e X X i
d o B
X X / X X / X X X X
d e C e a S e d
Oregon resident:
Fiscal year ending
mm
dd
yyyy
mm
dd
yyyy
9
9
K
F
P
J
S l a S T N a m e X X X X X X X X X X X S f i r S T N a m e X X i
d o B
X X / X X / X X X X
d e C e a S e d
From
To
10
10
e X T e N S i o N f i l e d
a d d r e S S 1 X X X X X X X X X X X X X X X X X X X X X X X X X X X
P H o N e
X X X - X X X - X X X X
Last name
First name and initial
Social Security No. (SSN)
Date of birth
(mm/dd/yyyy)
11
11
a d d r e S S 2 X X X X X X X X X X X X X X X X X X X X X X X X X X X
8 8 8 6
–
–
Deceased
12
12
Spouse’s/RDP’s last name if joint return
Spouse’s/RDP’s first name and initial if joint return
Spouse’s/RDP’s SSN if joint return
C i T Y X X X X X X X X X X X X X X X X X S T Z i P X X X X X X X
N e W N a m e / a d d r e S S
Date of birth
f o r m 2 4 f i l e d
(mm/dd/yyyy)
13
13
–
–
C o U N T r Y X X X X X X X X X X X X X X X
f o r C o m P U T e r U S e o N l Y
Deceased
14
14
f i l i N g S T a T U S :
X X X X X X X X X X X X X X X X X X X X X
Current mailing address
Telephone number
15
15
(
)
S P o U S e :
X X X X X X X X X X X X X X X S S N - X X - X X X X
16
16
City
State
ZIP code
Country
P a r T N e r :
X X X X X X X X X X X X X X X S S N - X X - X X X X
If you filed a return last year, and your
17
17
name or address is different, check here
q U a l i f Y i N g N a m e :
X X X X X X X X X X X X X X X X X X
18
18
•
PRINT 2-D BARCODE HERE
e X e m P T i o N S :
Filing
1
Single
Exemptions
19
19
Status
•
•
6 a S e l f :
2a
r e g U l a r
d i S a B l e d
X
Married filing jointly
Total
20
20
2b
Registered domestic partners (RDP) filing jointly
Check
6 B S P o U S e / r d P :
r e g U l a r
d i S a B l e d
X
6a
6a
21
Yourself ...........
Regular
...... Severely disabled
....
21
only
3a
Married filing separately:
6 C a l l d e P e N d e N T S :
X X X X X X X X X X X X X X
X X
one
6b
b
22
Spouse/RDP ...
22
Regular
...... Severely disabled
......
Spouse’s name _____________________________ Spouse’s SSN ___________________
⁄
box
1
6 d d i S a B l e d C H i l d r e N o N l Y :
X X
Minimum
" white space
•
3b
8
Registered domestic partner filing separately:
6c
c
23
All dependents
23
First names __________________________________
X X X X X X X X X X X X X X X X X X X X X X X X X X X X X
around all four sides of barcode
Partner’s name _____________________________ Partner’s SSN ___________________
•
6d
d
24
Disabled
24
First names __________________________________
4
Head of household:
Person who qualifies you ________________________________
6 e T o T a l e X e m P T i o N S :
X X
children only
•
Total
6e
25
25
5
Qualifying widow(er) with dependent child
(see instructions)
7 a S e l f
:
6 5 o r o l d e r
B l i N d
•
•
26
26
•
•
•
7a
7b
You
7c
You have
7d
You filed
S P o U S e / r d P :
6 5 o r o l d e r
B l i N d
You were:
65 or older
Blind
27
Check all that apply
➛
filed an
federal
27
Oregon
Spouse/RDP was:
65 or older
Blind
extension
Form 8886
Form 24
28
28
Federal column (F)
Oregon column (S)
29
29
.00
•
.00
8 Wages, salaries, and other pay for work. Include all Forms W-2 ........................ 8F
8S
INCOME
30
30
•
.00
.00
9 Taxable interest income from federal Form 1040, line 8a ...................................... 9F
9S
31
31
.00
•
.00
10 Dividend income from federal Form 1040, line 9a ................................................. 10F
10S
32
32
.00
•
.00
11 State and local income tax refunds from federal Form 1040, line 10 .................... 11F
11S
33
33
•
.00
.00
12 Alimony received from federal Form 1040, line 11 ................................................ 12F
12S
34
34
.00
•
.00
Include
13 Business income or loss from federal Form 1040, line 12 ..................................... 13F
13S
35
35
proof of
.00
•
.00
14 Capital gain or loss from federal Form 1040, line 13 ............................................. 14F
14S
36
36
withholding
.00
•
.00
15 Other gains or losses from federal Form 1040, line 14 .......................................... 15F
15S
(W-2s,
37
37
.00
•
.00
1099s),
16 IRA distributions from federal Form 1040, line 15b ............................................... 16F
16S
38
38
payment,
•
.00
.00
17 Pensions and annuities from federal Form 1040, line 16b ..................................... 17F
17S
39
39
and payment
.00
•
.00
18 Rents, royalties, partnerships, etc., from federal Form 1040, line 17 .................... 18F
18S
voucher
40
40
.00
•
.00
19 Farm income or loss from federal Form 1040, line 18 ........................................... 19F
19S
41
41
•
.00
.00
20 Unemployment and other income from federal Form 1040, lines 19 through 21 ... 20F
20S
42
42
•
.00
•
.00
21 Total income. Add lines 8 through 20 .................................................................
21F
21S
43
43
.00
•
.00
22 IRA or SEP and SIMPLE contributions, federal Form 1040, lines 28 and 32 ......... 22F
22S
ADJUSTMENTS
44
44
TO INCOME
.00
•
.00
23 Education deductions from federal Form 1040, lines 23, 33, and 34 .................... 23F
23S
45
45
.00
•
.00
24 Moving expenses from federal Form 1040, line 26 ................................................ 24F
24S
46
46
•
.00
.00
25 Deduction for self-employment tax from federal Form 1040, line 27 .................... 25F
25S
47
47
.00
•
.00
26 Self-employed health insurance deduction from federal Form 1040, line 29 ........ 26F
26S
48
48
.00
•
.00
27 Alimony paid from federal Form 1040, line 31a ..................................................... 27F
27S
49
49
•
•
•
•
.00
.00
28y $
28 Other adjustments to income. Identify:
28x
28z
28F
28S
Schedule
50
50
•
.00
•
.00
29 Total adjustments to income. Add lines 22 through 28 ......................................
29F
29S
51
51
•
.00
•
.00
30 Income after adjustments. Line 21 minus line 29 ...............................................
30F
30S
52
52
•
•
.00
.00
ADDITIONS
31 Interest on state and local government bonds outside of Oregon .....................
31F
31S
53
53
•
•
.00
.00
32 Federal election on interest and dividends of a minor child ...............................
32F
32S
54
54
•
•
•
•
.00
.00
33y $
33 Other additions. Identify:
33x
33z
......
33F
33S
Schedule included
55
55
•
.00
•
.00
34 Total additions. Add lines 31 through 33 ............................................................
34F
34S
56
56
•
.00
•
.00
35 Income after additions. Add lines 30 and 34 ......................................................
35F
35S
57
57
•
.00
SUBTRACTIONS
36 Social Security and tier 1 Railroad Retirement Board benefits included on line 20F ..
36F
58
58
•
•
•
•
.00
.00
37y $
37 Other subtractions. Identify:
37x
37z
37F
37S
Schedule included
59
59
.00
.00
•
•
38F
38 Income after subtractions. Line 35 minus lines 36 and 37 .................................
38S
60
60
•
.
__ __ __
__ %
Carry this
39 Oregon percentage. Line 38S ÷ line 38F (not more than 100.0%)
39
61
61
amount to line 40
62
62
➛
NOW GO TO THE BACK OF THE FORM
63
63
150-101-055-2 (Rev. 12-12) DRAFT 1, 08-06-12
150-101-055 (Rev. 12-12) DRAFT 1, 08-06-12
64
64
65
65
8
8
8
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
4
4
5
5
5
5
5
5
5
5
5
5
6
6
6
6
6
6
6
6
6
6
7
7
7
7
7
7
7
7
7
7
8
8
1
2
3
5
6 7 8 9
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
3
4
5
0
4
82
66
66

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2012 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2012 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2014 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2014 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2013 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2013 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2008 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2008 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2010 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2010 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2006 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2006 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2007 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2007 Financial
Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2015 Form 40p - Oregon Individual Income Tax Return For Part-year Residents - 2015 Financial
Form 40p - 2004 Individual Income Tax Return For Part-year Residents Form 40p - 2004 Individual Income Tax Return For Part-year Residents Financial
Form 40p Web - 2004 Individual Income Tax Return For Part-year Residents Form 40p Web - 2004 Individual Income Tax Return For Part-year Residents Financial

Related Categories

Parent category: Financial
Download
Go
Page of 2