Form 1040a-Cm/os-3405a - Territorial Individual Income Tax Return 2008
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6DIVISION OF REVENUE AND TAXATION
COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS
TERRITORIAL INDIVIDUAL INCOME TAX RETURN
Form 1040A-CM
2008
Last name
Your social security number
Last name
Spouse’s social security number
Name and
Home address (number and street). If you have a P.O. box, see page 17
Apt. No.
Address
IMPORTANT !
You must enter SSN(s) above
1
Single
2
3
Filing Status
4
Head of household (with qualifying person). (See page 18.) If the qualifying person is a child but not your
Check only one box
dependent, enter this child’s name here.
5
Qualifying widow(er) with dependent child. (See page 19)
Exemptions
6a
Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax return, do not check box 6a.
No. of boxes
checked on
6b
Spouse
6a and 6b
(4)
If qualifying
No. of children
c
Dependent’s:
(2) Dependent’s social
(3) Dependent’s
child for child tax
on 6c who:
security number
relationship to you
(1) First name
Last name
lived with you
credit (see page 20)
did not live with
dependents see
you due to divorce
page 20
or separation
(see page 21)
Dependents on 6c
not entered above
Add numbers
entered on
d
Total number of exemptions claimed……………………………………………………………………………………………………………
lines above
A.
B.
C.
INCOME WITHOUT
INCOME WITHIN
TOTAL INCOME
SOURCE OF INCOME
AND Income not subject to rebate
AND Income subject to rebate
7
7
Wages, salaries, tips, etc. Attach Form(s) W-2 and W-2CM………………………………….....
8a
8
a. Taxable interest. Attach Schedule 1 if required…………………………………...................
b. Tax-exempt interest. DO NOT include on line 8a
(8b)
9
a. Ordinary dividends. Attach Schedule 1 if required…………………………………................
9a
b.
Income
(9b)
10 Capital gain distributions
(see page 24)…………………………………………….................
10
11 a. IRA distributions
b. Taxable amount (see page 24)
(11a)
11b
12 a. Pensions and annuities
b. Taxable amount (see page 25)
12b
(12a)
13 Unemployment compensation and Alaska permanent fund dividends.................................
13
14b
14 a. Social security ben
(14a)
b. Taxable amount (see page 27)
15a
15 a. Add amounts in all columns for lines 7 through 14b. This is your total income....................
b. Allocable percentage (see supplemental instructions).........................................................
15b
%
%
100%
16
16 Educator expense (see page 29)…………………………………..............................................
17
17 IRA deduction (see page 29)...................................................................................................
Adjusted gross
18
18 Student loan interest deduction (see page 31)........................................................................
income
19
19 Tuition and fees deductions. Attach Form 8917......................................................................
20 Add lines 16 through 19. These are your total adjustments................................................................................................................................................
20
21 Subtract line 20 from line 15a. Col. C. This is your adjusted gross income....................................................................................................................
21
For disclosure, Privacy Act and Paperwork Reduction Act Notice, see page 78.
Form 1040A-CM (2008)
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