Form Ri-1040es - Rhode Island Estimated Payment Coupons
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1
22004
RI-1040ES
Rhode Island Estimated Payment Coupons
Part 1
2004 Estimated Rhode Island Income Tax Worksheet
1. Federal AGI (Adjusted Gross Income) expected in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Net modifications to Federal AGI
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
3. Modified Federal AGI - combine lines 1 and 2 - (add net increases or subtract net decreases) . . . . . . . . . . . . . . . . . . . . .
3.
4. Rhode Island deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
6. Federal exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
7. Taxable income - subtract line 6 from line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
8. Figure your 2004 RI tax on amount on line 7 - (see 2004 Tax Rate Schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
9. Enter your 2003 RI income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9.
10.Enter the smaller of line 8 or 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10.
11.Estimated RI withholding and RI credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11.
12.Estimated RI income tax - subtract line 11 from line 10 (If under $250.00 no estimate is required) . . . . . . . . . . . . . . . . . .
12.
13.Computation of installment - check the box when the estimated payment is to be filed and enter amount indicated . . . . .
April 15, 2004
June 15, 2004
September 15, 2004
January 15, 2005
Enter 1/4 of line 12
Enter 1/3 of line 12
Enter 1/2 of line 12
Enter amount from line 12
13.
14.Enter amount of 2003 RI overpayment elected for credit to 2004 estimated tax. However, if you desire to spread
the credit, divide it by the number of installments and enter here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14.
15.Amount to be paid with this estimate - subtract line 14 from line 13 and enter here and on RI-1040ES, line 1 . . . . . . . . .
15.
Part 2
Record of Estimated Payments
Column B
Column C
Column D
Column A
2003 Overpayment
Total amount paid and credited
Payment
Check
Number
Number
Date
Amount
credit applied
(add column B and column C)
1.
2.
3.
4.
Total
Part 3
Amended Estimated Tax Schedule
16.Amended estimated income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16.
17.Amount of estimated tax paid to date and 2003 overpayment chosen for credit to 2004 estimated tax . . . . . . . . . . . . . . .
17.
18.Unpaid balance - subtract line 17 from line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18.
19.Balance due - divide line 18 by the remaining number of installments required to be paid . . . . . . . . . . . . . . . . . . . . . . . .
19.
DETACH HERE AND MAIL WITH YOUR PAYMENT
Form RI-1040ES
STATE OF RHODE ISLAND
2004 Payment Coupon
DIVISION OF TAXATION * ONE CAPITOL HILL, PROVIDENCE, RI 02908-5810
NAME
Return this coupon with check or money order
DUE DATE
payable to the R.I. Division of Taxation, One
ADDRESS
Capitol Hill, Providence, R.I. 02908-5810.
JANUARY 15, 2005
Please do not send cash with this coupon.
CITY
STATE
ZIP
ITE
YOUR SOCIAL SECURITY NUMBER
SPOUSE’S SOCIAL SECURITY NUMBER, IF JOINT PAYMENT
$
FILE ONLY IF YOU ARE MAKING A PAYMENT OF ESTIMATED TAX
1. ENTER
0 0
AMOUNT
DUE AND PAID
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