Form 740-Ez - Kentucky Individual Income Tax Return For Single Persons With No Dependents - 2003
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1K
I
I
T
R
ENTUCKY
NDIVIDUAL
NCOME
AX
ETURN
740-EZ
For Single Persons With No Dependents
42A740-EZ
:
2003
Revenue Cabinet
Your Social Security Number ➤
Name—Last, First, Middle Initial
➤
L
Mailing Address (Number and Street Including Apartment Number or P.O. Box)
A
B
E
City, Town or Post Office
State
ZIP Code
L
➤
1
2
3
POLITICAL
Designating $2 will not change your refund or tax due. Mark an X in
PARTY
Box 1 for Democratic, Box 2 for Republican, or Box 3 for No Designation.
FUND
Dollars
Cents
INCOME
1. Enter federal Adjusted Gross Income from Form 1040EZ, line 4.
0
0
This is your Kentucky Adjusted Gross Income (If $25,000 or less,
,
.
see Low Income Credit in instructions.) ...................................................................... 1
1
8
3
0
0
0
,
.
2. Standard deduction ................................................................................................... 2
0
0
,
.
3. Subtract line 2 from line 1. This is your Taxable Income ...................................... 3
0
0
,
.
4. Enter tax from Tax Table or Tax Computation for amount on line 3 ...................... 4
TAX
0
0
5.
__ . __ __
__ __ __
Multiply line 4 by the low income tax credit decimal amount
(
%)
.
5
and enter here ....................................................................................................................
0
0
,
.
6. Subtract line 5 from line 4. This is your Income Tax Liability ............................... 6
0
0
,
.
7. Enter Kentucky Use Tax ............................................................................................ 7
0
0
,
.
8. Add lines 6 and 7. This is your Total Tax Liability ................................................. 8
0
0
9. Enter Kentucky Income Tax withheld as shown on attached
,
.
2003 wage and tax statements ................................................................................. 9
0
0
,
.
AMOUNT OVERPAID
10. If line 9 is greater than line 8, enter
(see instructions) . 10
See instructions for a detailed description of funds.
0
0
11. a Nature and Wildlife Fund Contribution (Enter amount checked)
.
$2
$5
$10
Other
................
0
0
b Child Victims' Trust Fund Contribution (Enter amount checked)
.
$2
$4
Other
......................................
0
0
c Bluegrass State Games and U.S. Olympic Committee
.
Fund Contribution .............................................................................
0
0
.
d Veterans' Program Trust Fund Contribution ..................................
0
0
,
.
12. Add amounts contributed on lines 11a, 11b, 11c and 11d ..................................... 12
0
0
,
.
REFUND
13. Subtract line 12 from line 10. Amount to be refunded to you .......
13
14. If line 8 is larger than line 9, enter amount you owe. Enclose check
0
0
payable to Kentucky State Treasurer. Write your Social
,
.
Security number and "KY Income Tax—2003" on the check ......................
OWE
14
I, the undersigned, declare under penalties of perjury that I have examined this return, including any accompanying statements, and to
the best of my knowledge and belief, it is true, correct and complete.
(
➤
Your Signature
Telephone Number (daytime)
Date Signed
42A740EZ0313
Typed or Printed Name of Preparer Other Than Taxpayer
I.D. Number of Preparer
Date
REFUNDS
Kentucky Revenue Cabinet, Frankfort, KY 40618-0006.
Mail to:
-
PAYMENTS
Kentucky Revenue Cabinet, Frankfort, KY 40619-0008.
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