Form Il-1040 - Individual Income Tax Return - 2004
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Illinois Department of Revenue
2004
Form IL-1040
/
Individual Income Tax Return
0 5
or for fiscal year ending
Do not write above this line.
Step 1:
Personal Information
A
Your Social Security numbers in the order they appear on your federal return
–
–
–
–
Your Social Security number
Your spouse’s Social Security number
B
Print your personal information below
Your first name and initial
Your last name
Your spouse’s first name and initial
Your spouse’s last name (if different)
Mailing address
City
State
ZIP
C
Filing status (check one)
Single or head of household
Married filing jointly
Married filing separately
Widowed
Step 2:
Income
1
Federal adjusted gross income from your U.S. 1040, Line 36; U.S. 1040A, Line 21;
1
U.S. 1040EZ, Line 4; or U.S. TeleFile Tax Record, Line I
2
Federally tax-exempt interest and dividend income from your U.S. 1040 or 1040A, Line 8b;
2
or U.S. 1040EZ
- New -
3
3
Other additions to your income. Attach Schedule M.
Complete
Schedule M.
4
4
Add Lines 1 through 3. This is your total income.
Step 3:
Base Income
5
Income received from Social Security benefits and certain retirement plans
5
if included in Step 2, Line 1. Attach federal page 1, Form W-2, 1099-R.
6
6
Military pay earned if included in Step 2, Line 1. Attach military W-2.
7
7
Illinois Income Tax overpayment included in U.S. 1040, Line 10
8
U.S. Treasury bonds, bills, notes, savings bonds, and U.S. agency
8
interest from U.S. 1040, Schedule B, or U.S. 1040A, Schedule 1
9
9
Other subtractions to your income. Attach Schedule M.
- New -
Complete
Check if Line 9 includes any amount from Schedule 1299-C
Schedule M.
10
10
Add Lines 5 through 9. This is the total of your subtractions.
11
11
Subtract Line 10 from Line 4. This is your Illinois base income.
Step 4:
Exemptions
x
12
a Number of exemptions from your federal return
$2,000 a
See
b If someone else claimed you or your spouse as a dependent on
instructions
x
their return, see instructions to figure the number to write here.
$2,000 b
before
completing
+
=
x
c Check if 65 or older:
You
Spouse
$1,000 c
this step.
+
=
x
d Check if legally blind:
You
Spouse
$1,000 d
12
Add Lines a through d. This is your total Illinois exemption allowance.
Step 5:
Net Income
13
13
Residents only: Subtract Line 12 from Line 11. This is your net income. Skip Line 14.
14
Nonresidents and part-year residents only:
Check the box that applies to you during the year 2004.
Nonresident
Part-year resident
14
Illinois base income from Schedule NR. Attach Schedule NR.
Step 6:
Tax
15
Residents: Multiply Line 13 by 3% (.03). Write the result here. This is your tax.
Nonresidents and part-year residents: Write the tax from Schedule NR.
15
This amount may not be less than zero.
This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this information is REQUIRED. Failure to
provide information could result in a penalty. This form has been approved by the Forms Management Center. IL-492-0065
IL-1040 front (R-12/04)
Continue on to Page 2
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