Form 740-Np - Kentucky Individual Income Tax Return Nonresident Or Part-Year Resident - 2016 Page 4

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FORM 740-NP (2016)
Page 4 of 4
*1600030041*
SECTION D
A. Total from Attached
B. Kentucky
Federal Return
INCOME
1 Enter all wages, salaries, tips, etc. (attach wage
00
00
and tax statements) Do not include moving expense reimbursements.................. 1
00
00
2 Moving expense reimbursement (attach Schedule ME) ........................................... 2
00
00
3 Interest ........................................................................................................................... 3
00
00
4 Dividends ....................................................................................................................... 4
00
00
5 Taxable refunds, credits or offsets of state and local income taxes ......................... 5
00
00
6 Alimony received .......................................................................................................... 6
00
00
7 Business income or loss (attach federal Schedule C or C-EZ) .................................. 7
00
00
8 Capital gain or loss (attach federal Schedule D) ........................................................ 8
00
00
9 Other gains or losses (attach federal Form 4797) ...................................................... 9
00
00
10 (a) Federally taxable IRA distributions, pensions and annuities .......................... 10(a)
00
(
)
(b) Pension income exclusion (attach Schedule P if more than $41,110 per taxpayer) ... 10(b)
00
00
11 Rents, royalties, partnerships, estates, trusts, etc. (attach federal Schedule E) ....... 11
00
00
12 Farm income or loss (attach federal Schedule F) ...................................................... 12
00
00
13 Unemployment compensation (see instructions) ...................................................... 13
00
14 Taxable Social Security benefits .................................................................................. 14
00
00
15 Gambling winnings ...................................................................................................... 15
16 Other income (list type and amount)
00
00
16
00
00
17 Combine lines 1 through 16. This is your Total Income
17
ADJUSTMENTS TO INCOME
00
00
18 Educator expenses ........................................................................................................ 18
19 Certain business expenses of reservists, performing artists and
00
00
fee-basis government officials (attach federal Form 2106 or 2106-EZ) .................... 19
00
00
20 Health savings account deduction (attach federal Form 8889) ................................. 20
00
00
21 Moving expenses (attach Schedule ME) .................................................................... 21
00
00
22 Deductible part of self-employment tax...................................................................... 22
00
00
23 Self-employed SEP , SIMPLE, and qualified plans deduction .................................... 23
00
24 Self-employed health insurance deduction ................................................................ 24
00
00
25 Penalty on early withdrawal of savings ...................................................................... 25
26 Alimony paid (enter recipient’s name and Social Security number)
00
00
26
00
00
27 IRA deduction ................................................................................................................ 27
00
00
28 Student loan interest deduction .................................................................................. 28
00
00
29 Tuition and fees deduction ........................................................................................... 29
00
00
30 Domestic production activities deduction .................................................................. 30
00
31 Long-term care insurance premiums (see instructions) ............................................ 31
00
32 Health insurance premiums (see instructions) ........................................................... 32
33 Other deductions (list type and amount)
00
00
33
00
00
34 Add lines 18 through 33. Total Adjustments to Income ........................................... 34
00
00
35 Subtract line 34 from line 17. This is your Adjusted Gross Income ...................... 35
36 Divide line 35, Column B, by line 35, Column A. If amount is equal to or
greater than 100%, enter 100%. This is your Percentage of Kentucky
.
%
Adjusted Gross Income to Federal Adjusted Gross Income ..................................... 36

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