Form 39nr - Idaho Supplemental Schedule - 2009
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1
22009
39NR
IDAHO SUPPLEMENTAL SCHEDULE
F
O
R
For Form 43, Nonresident and Part-Year Resident Returns Only
M
EFO00087
09-21-09
Name(s) as shown on return
Social Security Number
Column A - Total
Column B - Idaho
.
A. Additions. See instructions, page 26.
.
1. Non-Idaho state and local bond interest and dividends ......................................
1
00
00
.
2. Idaho college savings account withdrawal ..........................................................
2
00
00
.
3. Other additions. Attach explanation ...................................................................
3
00
00
4. Total additions. Add lines 1 through 3. Enter on line 31, Form 43 ....................
4
00
00
B. Subtractions. See instructions, page 26.
.
.
1. Idaho net operating loss carryover
00
00
Idaho net operating loss carryback
Enter total here ................
1
. .
2
00
2. State income tax refund included in line 30, Column A, Form 43 .......................
3
00
00
3. Interest from U.S. Government obligations ........................................................
00
00
4
4. Child/dependent care. Attach federal Form 2441 ...............................................
. .
00
5
5. Social security and railroad benefits included in line 30, Column A, Form 43 ....
.
00
00
6. Idaho capital gains deduction. Attach Form CG ................................................
6
7
00
00
7. Idaho resident - Active duty military pay earned outside of Idaho ......................
. .
8. Idaho medical savings account - contributions and interest
00
00
8
Financial institution _______________ Account number ________________
.
00
00
9
9. Idaho college savings program ..........................................................................
. .
00
00
10. Adoption expenses .............................................................................................
10
11
00
00
11. Maintaining a home for the aged and/or developmentally disabled ...................
. .
12
00
00
12. Idaho lottery winnings, less than $600 per prize ................................................
13
00
13. Income earned on a reservation by an American Indian ...................................
. .
00
00
14
14. Worker's compensation insurance ......................................................................
00
00
15
15. Partner's and shareholder's pass-through subtractions .....................................
. .
00
00
16. Insulation of Idaho residence .............................................................................
16
17
00
00
17. Technological equipment donation .....................................................................
.
18
00
00
18. Health insurance premiums ................................................................................
00
00
19
19. Long-term care insurance ..................................................................................
00
20. Alternative energy device deduction
00
Year
Acquired
Type of Device
Total Cost
Percent
2009
$
X
40%
20a
00
00
a.
=
20%
2008
$
X
=
b.
20b
00
00
20%
2007
$
X
=
c.
20c
00
00
.
20%
=
d.
2006
$
X
20d
00
00
e. Add lines 20a through 20d .............................................................................
20e
00
00
21. Add lines 1 through 19 and 20e .........................................................................
21
00
00
. .
00
22. Retirement benefits deduction
a. If single enter $27,876, if married filing jointly enter $41,814 .........................
22a
00
.
See instructions,
b. Federal Railroad Retirement received ...........................................................
22b
00
page 30, for
c. Social Security benefits received ...................................................................
qualified retirement
22c
00
.
benefits to be
d. Balance. Line 22a minus lines 22b and 22c. If less than zero, enter zero .....
22d
00
included on lines
e. Qualified retirement benefits included in federal gross income .....................
00
22e
22e and 22g.
.
f. Column A benefits. Smaller of line 22d or line 22e ........................................
00
22f
g. Qualified retirement benefits included in Idaho gross income .......................
22g
00
.
h. Divide line 22g by line 22e .............................................................................
%
22h
.
i. Column B benefits deduction. Multiply line 22f by line 22h ...........................
22i
00
23. Nonresident military pay included in line 30, Column A, Form 43 ......................
. .
23
00
24. Bonus depreciation. Attach computations .........................................................
24
00
00
25. Other subtractions. Attach explanation ..............................................................
25
00
00
.
26. Total subtractions. Column A, add lines 21, 22f, 23, 24, and 25.
Column B, add lines 21, 22i, 24, and 25. Enter on line 32, Form 43 .................
26
00
00
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