Form 1040n - Nebraska Individual Income Tax Return - 2010

Nebraska Individual Income Tax Return

FORM 1040N

2010

for the taxable year January 1, 2010 through December 31, 2010 or other taxable year:

, 2010 through

,

Your First Name and Initial

Last Name

PLEASE DO NOT wRITE IN THIS SPACE

If a Joint Return, Spouse’s First Name and Initial

Last Name

Current Mailing Address (Number and Street or PO Box)

City, Town, or Post Office

State

Zip Code

IMPORTANT:

High School District Code

SSN(S) MUST bE ENTERED bELOw.

Your Social Security Number

Spouse’s Social Security Number

(must be entered using high

school codes)

(1)

Farmer/Rancher

(2)

Active Military

(1)

Deceased Taxpayer(s)

(first name & date of death):

1

Federal Filing Status

(1)

Single

(3)

Married, filing separately –

(4)

Head of Household

Spouse’s SSN:

(2)

Married, filing jointly

(5)

Widow(er) with dependent children

and Full Name

2a Check if YOU were:

2b

(1)

65 or older

(2)

Blind

Check here if someone (such as your parent) can claim you or

SPOUSE was:

65 or older

your spouse as a dependent: (1)

You

(2)

Spouse

(3)

(4)

Blind

3 Type of Return

(attach Schedule III)

(2)

Partial-year resident from

/

, 2010 to

/

/

(1)

Resident

Nonresident (attach Schedule III)

(3)

4 Federal exemptions (number of exemptions claimed on your 2010 federal return) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

5 Federal adjusted gross income (AGI) (Federal Form 1040EZ, line 4; Federal Form 1040A, line 21;

Federal Form 1040, line 37) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

00

6 Nebraska standard deduction (if you checked any boxes on line 2a or 2b above,

see instructions; otherwise, enter $11,400 if married, filing jointly or qualified widow[er];

6

$5,700 if single; $8,400 if head of household; or $5,700 if married, filing separately)

00

7 Total itemized deductions (Federal Schedule A, line 29 – see instructions) . . . . . . .

7

00

8 State and local income taxes (Federal Form 1040, line 5, Schedule A –

see instructions .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8

00

9 Nebraska itemized deductions (line 7 minus line 8) . . . . . . . . . . . . . . . . . . . . . . . . .

9

00

10 Enter the amount from line 6 or line 9, whichever is greater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

00

11 Nebraska income before adjustments (line 5 minus line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

00

12 Adjustments increasing federal AGI (line 50, from attached Nebraska Schedule I) 12

00

13 Adjustments decreasing federal AGI (line 60, from attached Nebraska Schedule I) 13

00

If the amount on line 13 is ONLY for a state income tax refund deduction, check this box:

(see instructions)

(NOTE: If line 12 is -0-, and you check this box, do not complete Nebraska Schedule I .)

00

14 Tax Table income (enter line 11 plus line 12 minus line 13) . If less than -0-, enter -0- . . . . . . . . . . . . . . . . . . . 14

15 Nebraska income tax (residents use Nebr . Tax Table; others use Nebr . Sch . III) . . . 15

00

16 Nebraska minimum or other tax:

Federal Alternative Minimum tax (Recalculated Form 6251) . . .$______________

Federal Tax on Lump Sum Distributions (Form 4972) . . . . . . . .$______________

Federal Tax on Early Distributions (Lesser of Form 5329 or

line 58 Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$______________

Total

$______________

Multiply total by 29 .6% ( .296) and enter the result on line 16 . . . . . . . . . . . . . . . . . . 16

00

17 Total Nebraska tax before personal exemption credit (add lines 15 and 16) . Do not pay the amount on this

00

line . Pay the amount from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

COMPLETE REVERSE SIDE

8-417-2010