Form G-65 - General Excise Tax Computation Worksheet For Persons With A Certified Disability - 2005
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FORM G-65
STATE OF HAWAII - DEPARTMENT OF TAXATION
(REV. 2005)
GENERAL EXCISE TAX COMPUTATION WORKSHEET
FOR PERSONS WITH A CERTIFIED DISABILITY
Attach a copy of this worksheet to your return.
Disabled Taxpayer’s Name
HI Tax I.D. No. W _ _ _ _ _ _ _ _ - _ _
Last 4 digits of your SSN or FEIN
Filing period
1. Enter your share of the amounts listed in Part II, Column c of Form G-45 or Form G-49 for the following
activity classifications:
a. Retailing .................................................................................
$
b. Services Including Professional .............................................
$
c. Contracting .............................................................................
$
d. Theater, Amusement and Broadcasting .................................
$
e. Interest ...................................................................................
$
f. Commissions...........................................................................
$
g. Transient Accommodations Rentals.......................................
$
h. Other Rentals .........................................................................
$
i. All Others.................................................................................
$
2. Enter the total of lines 1a through 1i ..............................................................................
$
3. Multiply the amount on line 2 by .005 ............................................................................
$
4. Total of the lines in Part II, Column c of Form G-45 or Form G-49................................
$
5. Subtract the amount on line 2 from the amount on line 4 ..............................................
$
6. Multiply the amount on line 5 by .04 ..............................................................................
$
7. Total Part II Taxes. Add the amounts on line 3 and line 6.
Also enter this amount on Form G-45 or Form G-49 in the “Part II – Taxes box. ..........
$
PURPOSE OF THIS WORKSHEET
These benefits are also available to corporations all of
Use this worksheet to calculate the amount of tax to report
whose outstanding shares are owned by individuals who are
on your monthly, quarterly, semi-annual, or annual general
blind, deaf, or totally disabled and to general, limited, or
excise tax return, Forms G-45 and G-49.
limited liability partnerships, all of whose partners are blind,
deaf, or totally disabled, and limited liability companies, all of
Use a separate sheet for each general excise tax return.
whose members are blind, deaf, or totally disabled.
For each taxable period, attach a copy of this worksheet to
your general excise tax return for that period.
To be eligible for these benefits, your impairment or
disability must be certified by an appropriate medical doctor
GENERAL INSTRUCTIONS
on Form N-172, Claim for Tax Exemption by Person with
The General Excise Tax Law permits a person with
Impaired Sight or Hearing or Totally Disabled Person and
impaired sight, impaired hearing, or who is totally disabled to
Physician’s Certification , and must then be submitted to the
claim certain tax benefits. First, the person may exclude up
Department of Taxation. Furthermore, the disabled person
to $2,000 of gross income per year from the general excise
cannot have earned income of more than $30,000 for the tax
tax. Second, the person will be taxed on any remaining
year from all sources.
For more information on earned
gross income at a maximum rate of ½ of 1%.
FORM G-65
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