Form 511 - State Of Oklahoma Income Tax Return

2004 Form 511 • page 2

PART THREE: Tax, Payments and Credits

Total from line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If line 7 is equal to or larger than 1, complete line 20. If line 7 is smaller than line 1, see Schedule 511-F.

Oklahoma child care credit (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Credit for taxes paid to another state (enclose Form 511TX) . . . . . . . . . . . . . . . . . . . .

Other credits (511CR) . . . . . . . Please list 511CR line number claimed here

Line 19 minus lines 20, 21 and 22

. . . . . . . . . . . . . .

Do not enter less than zero.

Use Tax (see instructions on page 10)

Check here if no use tax is due. . . . . . . . .

Balance (add lines 23 and 24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Oklahoma withholding

. .

(enclose W-2s, 1099s or other withholding statements)

2004 Oklahoma estimated tax payments .

(qualified farmer

)

2004 payment with extension . . . . . . . . . . . . . . . . . . . . . . . . . .

Low Income Property Tax Credit (enclose Form 538-H) . . . . .

Sales Tax Relief Credit (enclose Form 538-S, see instructions)

Tornado Tax Credit

. . .

(enclose Form 509, Form 510 or Form 575)

If line 7 is equal to or larger than line 1, complete line 32. If line 7 is smaller

than line 1, see Schedule 511-G. If you are not required to file, see instructions.

Oklahoma Earned Income Credit (see instructions) . . . . . . . . .

Total payments and credits (add lines 26-32) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART FOUR: Overpaid

Overpayment (if line 33 is greater than line 25)

. .

subtract line 25 from line 33

Overpayment

Amount from line 34 to be credited to your 2005 estimated tax

Schedule 511-H provides you with the opportunity to make a financial gift from your refund to a variety

of Oklahoma organizations. Please place the line number of the organization from Schedule 511-H in the

oval below. If you give to more than one organization, please put a “99” in the oval below.

Donations from your refund.

(total from Sch. 511-H, line 10)

Total deductions from refund (add lines 35 and 36) . . . . . . . . . . . . . . . . . . . . . . . . . . .

For instructions, please see page 13

Direct Deposit Option:

of your Individual Resident Income Tax Packet.

Yes! Please deposit my refund in my

checking account

savings account

Routing Number:

Account Number:

Amount to be refunded (line 34 minus line 37) . . . . . . . . . . . . . . . . . . . . . .

Refund

PART FIVE: Tax Due

Tax Due (if line 25 is greater than line 33)

. . . . . . . .

subtract line 33 from line 25

Tax Due

Donation: Oklahoma Organ Donor Education Fund . . . .

$______

Underpayment of estimated tax . . . . . . . . . . . . . . (annualized installment method

)

For delinquent payment (add penalty of 5% plus interest at 1.25% per month) . . . . . .

Total tax, donation, penalty and interest (add lines 39-42) . . . . . . . .

Balance Due

Check this box if the Oklahoma Tax Commission may

Under penalty of perjury, I declare that the information contained in this document,

discuss this return with your tax preparer.

attachments and schedules are true and correct to the best of my knowledge and belief.

Taxpayer’s signature

Date

Spouse’s signature

Date

Paid Preparer’s signature

Date

Paid Preparer’s address and phone number

Spouse’s

Taxpayer’s

occupation

Daytime Phone

Paid Preparer’s I.D. Number

(optional)

Check this box if the taxpayer did not want this

Mailing Address: P.O. Box 26800, Oklahoma City, Oklahoma 73126-0800

return filed electronically.

The Oklahoma Tax Commission is not required to give actual notice to taxpayers of changes in any state tax law.

Form 511 - State Of Oklahoma Income Tax Return - 2004 Page 2

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