Form Sc1040a - Individual Income Tax Return - Short Form - 2001
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1FULL-YEAR RESIDENTS ONLY
Do not write in this space - OFFICE USE
SC1040A
(Rev. 9/11/01)
SOUTH CAROLINA
INDIVIDUAL INCOME TAX RETURN
SHORT FORM 2001
For the year January 1 - December 31, 2001, or other tax year beginning
2001 and ending
20
Print Your first name and Initial
(Sr, Jr, 2nd, 3rd, 4th)
Last name
Your Social Security number
Spouse's first name and Initial, if married filing jointly
Spouse's last name, if different
Spouse's Social Security number
Area Code
Daytime telephone
Do not write in this space - OFFICE USE
Present home address (number and street, or P. O. Box)
Apt. No.
City, state and ZIP code
County code
If you do not wish to receive a booklet next year, but need a pre-addressed label for your 2002 return, check here.
FEDERAL
(1)
Single
(3)
Married filing separately. Enter spouse's SSN # here:
FILING
(2)
Married filing jointly
(4)
Head of household
(5)
Widow(er) with dependent child
STATUS
Federal Exemptions: Enter the number of exemptions from your 2001 federal return.
_________
How many of the exemptions listed above were under the age of 6 years on December 31, 2001?
_________
Dollars
Cents
1 FEDERAL TAXABLE INCOME from your federal Form 1040A, line 25, or 1040EZ, line 6. If this is a
negative amount or zero, enter zero. This amount is your State Taxable Income. If you itemized on your
federal tax return (Form 1040), Do Not Use This Form, use SC1040.
00
1
2 Deduction for dependents under 6 years of age, see instructions. All other adjustments to income are
00
2
allowed only on Form SC1040.
00
3 Subtract line 2 from line 1. Enter the difference here.
3
00
4
4 TAX: Enter tax from SOUTH CAROLINA tax tables.
5 Child and Dependent Care. Federal EXPENSE from form 2441:
00
5
$ _____________ x .07 (7%)
00
6
6 Two Wage Earner Credit from Schedule W. (See instructions)
00
7 Total Non-Refundable Credit. Add lines 5 and 6.
7
00
8 SUBTRACT line 7 from line 4. Enter the difference BUT NOT LESS THAN ZERO.
8
WITHHOLDING
00
9 South Carolina income tax withheld. (Attach STATE'S copy of form W-2, 1099).
9
00
10 If line 9 is larger than line 8, subtract line 8 from line 9 and enter the OVERPAYMENT.
10
00
11 If line 8 is larger than line 9, subtract line 9 from line 8 and enter the AMOUNT DUE.
11
00
12 USE TAX (Due on Out-of-state Purchases. See instructions.)
12
00
00
17 Gift of Life Trust Fund
13 Endangered Wildlife Fund
00
00
14 Children's Trust Fund
18 DARE Fund
00
00
15 Eldercare Trust Fund
19 First Steps Fund
00
00
16
20 Heritage Trust Fund
Veterans' Trust Fund
00
21 ADD lines 12 through 20 and enter the total here.
21
22 NET REFUND: If line 21 is larger than line 10 go to line 23. Otherwise, subtract line 21
REFUND
00
22
from line 10 and enter the AMOUNT TO BE REFUNDED TO YOU.
23 NET DUE: Add lines 11 and 21, or if line 21 is larger than line 10 subtract line 10 from
BALANCE
line 21. Enter the AMOUNT YOU OWE. Attach a check or money order for the full
amount payable to "SC Department of Revenue." Write your Social Security number
DUE
00
23
and "2001 Form SC1040A" on the check.
I declare that this return and all attachments are true, correct and complete to the best of my knowledge and belief.
Your Signature
Date
Spouse's Signature (if jointly, BOTH must sign)
I authorize the Director of the Department of Revenue or delegate to
Preparer's Printed Name
Yes
No
discuss this return, attachments and related tax matters with the preparer.
If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
Paid
Preparer's
Prepared by
Date
Address
Use Only
City
State
Zip
EI Number
Phone Number
MAIL ORIGINAL RETURN TO : SHORT FORM PROCESSING CENTER, P.O. BOX 101104, COLUMBIA, S.C. 29211-0104
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