Schedule F Individual - Other Income - 2009 printable pdf download

Schedule F Individual

Rev. 01.10

2009

OTHER INCOME

Taxable year beginning on _________________, _____ and ending on ________________, _____

Taxpayer's name

Social Security Number

Fill in one:

(01)

1 Taxpayer

2 Spouse

3 Both

Part I

Interest

Column F

Column A

Column B

Column C

Column E

Column D

Interest subject

Interest from IRA

Interest not subject to

Eligible interest

Other

Employer

Account

to withholding

distributions to

withholding

subject to

Payer's name

interest

Identification Number

Number

from financial

Government

withholding

institutions (17%)

institutions (10%)

Pensioners

institutions

(02)

(03)

(04)

(05)

(06)

(07)

(08)

(09)

(32)

(14)

(19)

(27)

(24)

Subtotal of interest ...................

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

(10)

(15)

(28)

(20)

(25)

Less: Interest exclusion

See instructions

(

) ......................................................................................

(16)

(29)

(33)

(21)

(26)

Total interest ...........................................................................................................................

(11)

(34)

Add line 3, Columns D and F.........................................................................................................

(17)

(22)

(30)

Tax: Enter 17% of line 3B and 10% of lines 3A, 3C and 3E ...........................................................

(12)

(35)

Total tax (Determine the total of line 5. Enter in Part 4, line 18 of the return or on line 19 of

Schedule CO Individual, 50% to each Column)

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

(18)

(23)

(31)

Tax withheld (Submit Forms 480.6B, 480.6SE, 480.6CI, 480.7 and 480.7B, as applicable) .................

(13)

Total tax withheld (Determine the total of line 7. Enter on Schedule B Individual, Part IIl, line 4)............................................................................................................................................................

......

(36)

Option to pay taxes from interest in any of Columns A, B, C and E as ordinary income (Enter here the total of lines 3A, 3B, 3C and 3E, as applicable) ................................................................................

(37)

10.

Total interest (Add lines 4 and 9. Transfer to Part 2, line 2A of the return or to line 3A of Schedule CO Individual)..............

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

(38)

Retention Period: Ten (10) Years