Form 39nr - Idaho Supplemental Schedule - 2009 Page 2
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1
2Form 39NR - 2009
EFO00087p2
Page 2
09-21-09
Name(s) as shown on return
Social Security Number
C. Credit for Income Tax Paid to Other States by Part-Year Residents. See instructions, page 31.
.
Nonresidents cannot claim this credit. Idaho residents on active military duty, complete Part D below.
This credit is being claimed for taxes paid to: __________________________________
(State name)
1. Idaho adjusted income from line 33, Column B, Form 43 ........................
1
00
Attach a copy of the
2. Other state's adjusted income ..................................................................
00
2
income tax return and
3. Amount of income taxed by Idaho, and also taxed by another state .......
00
a separate Form 39NR
3
for each state for which
4. Idaho tax, line 44, Form 43 .......................................................................
4
00
a credit is claimed.
5. Divide line 3 by line 1. Enter percentage here .........................................
%
5
6. Multiply line 4 by line 5 ....................................................................................................................
6
00
7. Other state's tax due less its income tax credits ......................................
00
7
8. Divide line 3 by line 2. Enter percentage here ..........................................
%
8
9. Multiply line 7 by line 8 ...................................................................................................................
9
00
10. Enter the smaller of line 6 or 9 here and on line 45, Form 43 ........................................................
10
00
D. Credit for Income Tax Paid to Other States by Idaho Residents on Active Military Duty.
.
See instructions, page 32.
This credit is being claimed for taxes paid to: __________________________________
(State name)
1. Idaho tax, line 44, Form 43 .......................................................................
1
00
Attach a copy of the
income tax return and
2. Other state's adjusted income ..................................................................
2
00
a separate Form 39NR
3. Idaho adjusted income from line 33, Column B, Form 43 ........................
3
00
for each state for which
4. Divide line 2 by line 3. Enter percentage here ..........................................
%
a credit is claimed.
4
5. Multiply line 1 by line 4. Enter amount here ...................................................................................
00
5
6. Other state's tax due less its income tax credits ............................................................................
6
00
7. Enter the smaller of line 5 or 6 here and on line 45, Form 43 ........................................................
7
00
E. Maintaining a Home for a Family Member Age 65 or Older, or a Family Member With a
Developmental Disability. See instructions, page 32.
1. Did you maintain a home for an immediate family member age 65 or older and provide more than
Yes
No
one-half of his/her support? You and your spouse do not qualify .................................................
2. Did you maintain a home for an immediate family member with a developmental disability and
Yes
No
provide more than one-half of his/her support? You and your spouse may qualify .......................
3. List each family member you are claiming:
Check here if
Date of Birth of
Name of Family Member
Social Security Number
Relationship to Person
developmen-
Family Member
First Name
Last Name
of Family Member
Filing Return
tally disabled
4. Total amount claimed ($100 for each qualifying member but not more than $300).
Enter on line 65, Form 43. (Credit cannot be claimed if you took $1,000 deduction on
Part B, line 11.) ................................................................................................................
00
4
F. Dependents: (Continued from Form 43, page 1)
Social Security Number
First Name
Last Name
G. Standard Deduction. See page 32 of the instructions.
1. Real estate taxes from federal Schedule L, line 9 ...........................................................................
1
00
2. Disaster loss from federal Schedule L, line 6 ..................................................................................
2
00
3. Qualified motor vehicle tax deduction from federal Schedule L, line 20 ..........................................
3
00
4. Total of lines 1 through 3 .................................................................................................................
4
00
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