Form 40 - Idaho Individual Income Tax Return With Instructions

Form 40 - 2009

Page 2

JOHN TAXPAYER

EFO00089p2 08-31-09

23. Tax amount from line 22 ............................................................................................................................................

CREDITS. Limits apply. See instructions, page 8.

24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns

25. Credit for contributions to Idaho educational entities ......................................................

26. Credit for contributions to Idaho youth and rehabilitation facilities ..................................

27. Credit for live organ donation expenses ..........................................................................

28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 .........

29. TOTAL CREDITS. Add lines 24 through 28 .............................................................................................................

30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero ..................................................................

OTHER TAXES. See instructions, page 9.

31. Fuels tax due. Attach Form 75 .................................................................................................................................

32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases ..............................................................

33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 ..................................

34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER ....................................................

_____

NRF

35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments ..................

36. TOTAL TAX. Add lines 30 through 35 .......................................................................................................................

DONATIONS. See instructions, page 9.

I wish to donate to:

37. Nongame Wildlife Conservation Fund ...........

________ 38. Idaho Children's Trust Fund ............ _________

39. Special Olympics Idaho .................................

________ 40. Idaho Guard and Reserve Family ... _________

41. American Red Cross of Greater Idaho Fund ..

________ 42. Veterans Support Fund ................... _________

43. Idaho Foodbank ............................................

________

44. Enter total donations. Add lines 37 through 43 ........................................................................................................

45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................

PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.

180

46. Grocery credit. Computed Amount (from worksheet) ..................................................................

______________

To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46.

180

To receive your grocery credit, enter the computed amount on line 46 ....................................................................

47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ...............

48. Special fuels tax refund ________________

Gasoline tax refund ___________________

Attach Form 75

49. Idaho income tax withheld. Attach Form(s) W-2 ......................................................................................................

50. 2009 Form 51 payment(s) and amount applied from 2008 return .............................................................................

51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 ....................................................................

180

TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.

52. TAX DUE. Subtract line 51 from line 45 .........................................................................................................

53. Penalty ____________ Interest from the due date

____________

Enter total ..............................................

Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account ....................

54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ......

55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid .......................................................

180

56. REFUND. Amount of line 55 to be refunded to you .......................................................................................

180

57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ......................................................

58. DIRECT DEPOSIT. See instructions, page 12.

Check if final deposit destination is outside the U.S.

Type of

Checking

Routing No.

Account No.

Account:

Savings

AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.

59. Total due (line 54) or overpaid (line 55) on this return ...............................................................................................

60. Refund from original return plus additional refunds ...................................................................................................

61. Tax paid with original return plus additional tax paid .................................................................................................

62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 ....................................................................

Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.

Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.

Your signature

Spouse's signature (if a joint return, BOTH MUST SIGN)

SIGN

HERE

Date

Preparer's EIN, SSN, or PTIN

Daytime phone

{¢U¦}

Paid preparer's signature