Form 1 Npr - Nonresident And Part-Year Resident Wisconsin Income Tax - 2015
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41NPR
2015
For the year Jan. 1-Dec. 31, 2015, or other tax year
Nonresident & part-year resident
Wisconsin income tax
beginning
, 2015
ending
, 20
.
Check here if this is an amended return
Complete form using
BLACK
INK
Your legal last name
Legal first name
M.I.
Your social security number
If a joint return, spouse’s legal last name
Spouse’s legal first name
M.I.
Spouse’s social security number
Home address (number and street). If you have a PO Box, see page 7
Apt. no.
Tax district
Check below then fill in either the name of Wisconsin city,
village, or town, and the county in which you lived at the
City or post office
State
Zip code
end of 2015 or before leaving Wisconsin (nonresidents
leave blank).
Filing status
Special
City
Village
Town
conditions
City, village,
Single
or town
Married filing joint return
Legal last name
(even if only one had income)
County of
Married filing separate return.
Legal first name
M.I.
Fill in spouse’s SSN above
School district number
See page 43
and full name here ...............
Head of household (with
qualifying person),
.
(see page 8)
Also, check here if married ...
Resident status
Check the status that applies
You
Spouse
Full-year resident of Wisconsin
Nonresident of Wisconsin; state of residence
(2-letter state abbreviation)
Note: Complete residence questionnaire, page 51.
Part-year resident of Wisconsin from
to
mm
dd
yyyy
mm
dd
yyyy
Print numbers like this
NO COMMAS
NO CENTS
A. Federal column
B. Wisconsin column
Not like this
Income
.00
.00
1 Wages, salaries, tips, etc. (see page 10) . . . . . . . . . . . . . . . . . . . . . . . .
1
.00
.00
2 Taxable interest (see page 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
.00
.00
3 Ordinary dividends (see page 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4 Taxable refunds, credits, or offsets of state and local income taxes
.00
Not taxable
(from federal Form 1040, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
.00
.00
5 Alimony received (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
.00
.00
6 Business income or (loss) (see page 13) . . . . . . . . . . . . . . . . . . . . . . . .
6
.00
.00
7 Capital gain or (loss) (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
.00
.00
8 Other gains or (losses) (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . .
8
.00
.00
9 IRA distributions (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
.00
.00
10 Pensions and annuities (see page 14) . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Rental real estate, royalties, partnerships, S corporations, trusts, etc.
.00
.00
(see page 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
.00
.00
12 Farm income or (loss) (see page 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
.00
.00
13 Unemployment compensation (see page 15) . . . . . . . . . . . . . . . . . . . . 13
.00
Not taxable
14 Social security benefits (see page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . 14
.00
.00
15 Other income (see pages 16-22). Enclose Schedule M . . . . . . . . . . . . 15
.00
.00
16 Add lines 1 through 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
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