Form 40p - Individual Income Tax Return - 2001 Page 2
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1
2Clear Form
Form 40P
Page 2 –
2001
Oregon column
Federal column
36 Amount from front of form, line 35
36
•
37
37 Social Security and tier 1 railroad retirement income included on line 19
SUBTRACTIONS
•
•
38 Other subtractions. Identify
38a
38b
•
39a
39b
39 Income after subtractions. Line 36 minus lines 37 and 38
%
.
40 Oregon percentage. Line 39b ÷ line 39a
40
(not more than 100%)
41 Amount from line 39a (federal amount)
41
DEDUCTIONS
•
42 Itemized deductions from federal Schedule A, line 28
42
AND
•
43 State income tax claimed as itemized deduction. See instructions, page 24
43
EITHER,
MODIFICATIONS
44 Net Oregon itemized deductions. Line 42 minus line 43
NOT BOTH
44
45 Standard deduction from page 24
45
•
46 2001 federal tax ($0 – $3,000, see instructions for the correct amount)
46
•
47 Other deductions and modifications. Identify
47
48 Add lines 45, 46, and 47 or lines 44, 46, and 47. Fill in the larger amount
48
•
•
49 Taxable income. Line 41 minus line 48
49
OREGON
50 Tax on amount shown on line 49. See page 25
50
TAX
•
51 Oregon income tax. Line 50
Oregon percentage from line 40
51
ADD TOGETHER
•
52
52 Interest on certain installment sales
53 TOTAL TAX. Add lines 51 and 52
53
CREDITS
54
54 Exemption credit. Line 6e
$142
Oregon percentage from line 40
•
55 Earned income credit. See instructions, page 25
55
•
56 Working family credit. See instructions, page 26
56
ADD TOGETHER
•
57
57 Retirement income credit. See instructions, page 26
•
58 Child and dependent care credit. See instructions, page 28
58
•
59
59 Credit for income taxes paid to another state. Attach proof
•
60 Other credits. Identify
60
61 Total credits. Add lines 54 through 60
61
62 Net income tax. Line 53 minus line 61. If line 61 is more than line 53 fill in -0-
•
•
62
•
63 Oregon income tax withheld from income. Attach Forms W-2 and 1099
63
TAX
ADD TOGETHER
•
PAYMENTS,
64
64 Estimated tax payments for 2001 and payments made with your extension
PENALTY,
65 Total payments. Add lines 63 and 64
65
AND
•
•
66 Overpayment.
Is line 62 less than line 65? If so, line 65 minus line 62
OVERPAYMENT
66
INTEREST
•
•
TAX-TO-PAY
67
67 Tax-to-pay.
Is line 62 more than line 65? If so, line 62 minus line 65
•
68 Penalty and interest for filing or paying late. See instructions on page 28
68
ADD TOGETHER
•
69
69 Interest on estimated tax underpayment.
If Form 10 is attached, check
70 Total penalty and interest due. Add lines 68 and 69
70
Stop here! AMOUNT-YOU-OWE
71
71 Amount-you-owe.
Add lines 67 and 70
REFUND
72
72 Refund.
Is line 66 more than line 70? If so, line 66 minus line 70
•
73 Estimated tax.
Fill in the part of line 72 you want applied to your 2002 estimated tax
73
•
DONATIONS
74
74 Oregon Nongame Wildlife
$1,
$5,
$10,
Other $ _____
•
I wish to
75 Child Abuse Prevention
$1,
$5,
$10,
Other $ _____
75
These will
donate
•
76
76 Alzheimer’s Disease Research
$1,
$5,
$10,
Other $ _____
reduce
part of my
•
your refund
tax refund
77
77
$1,
$5,
$10,
Other $ _____
Stop Domestic & Sexual Violence
to the
•
78
$1,
$5,
$10,
Other $ _____
78
AIDS/HIV Education and Services
following
•
•
fund(s)
79
79 Other charity. Enter code ____
$1,
$5,
$10,
Other $ _____
80 Total. Add lines 73 through 79. Total can’t be more than your refund on line 72
80
81
NET REFUND.
Line 72 minus line 80. This is your net refund
NET REFUND
81
DIRECT
82 For direct deposit of your refund, see the instructions on pages 3 and 30.
•
Type of account:
Checking or
Savings
DEPOSIT
•
•
Routing No.
Account No.
Attach a Copy of Federal Form 1040, 1040A, or 1040EZ. Do Not Attach Other Federal Schedules.
Under penalties for false swearing, I declare that I have examined this return, including accom-
I authorize the Department of Revenue to discuss
panying schedules and statements. To the best of my knowledge and belief it is true, correct,
this return with this preparer or any member of his
Yes
No
and complete. If prepared by a person other than the taxpayer, this declaration is based on all
or her firm.
information of which the preparer has any knowledge.
Your signature
Date
Signature of preparer other than taxpayer
License No.
X
X
SIGN
HERE
Spouse’s signature (If filing jointly, BOTH must sign)
Date
Telephone No.
Address
X
150-101-055 (Rev. 10-01)
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