Form 1040s-Me - Maine Individual Income Tax - 2004
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300
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*0402210*
MAINE INDIVIDUAL INCOME TAX
1040S-ME RESIDENT SHORT FORM
IMPORTANT!
You must enter your SSN(s) below.
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Your Social Security Number
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Spouse’s Social Security Number
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Home Phone Number
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Work Phone Number
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Check this box if your name or address has changed since last year.
NOTE: If either spouse is deceased, enter the date
Write your correct name(s), address, and ssn(s) in the spaces provided
of death on the back of this page in the spaces
above. Do NOT use the label if your name or address has changed.
provided above the signature area.
1 Maine Clean Election Fund – (See instructions on page 6.) NOTE: Checking
2 Check here if you were engaged in
the box will not increase your tax or reduce your refund.
YES
NO
COMMERCIAL FARMING OR FISHING
Do you want $3 to go to this fund .......................................................
during 2004. (See Instructions)
If a joint return, does your spouse want $3 to go to this fund ............
FILING STATUS (Check one)
3
Single
8 CHECK IF:
You
Spouse
were
was
4
Married filing joint return (Even if only one had income)
65 or over ............. 8a
8c
5
Married filing separate return. Enter spouse’s social security number and full name above.
6
Head of household (With qualifying person)
Blind ..................... 8b
8d
7
Qualifying widow(er) with dependent child
(Year spouse died
)
9
Enter the TOTAL number of EXEMPTIONS claimed on your federal return .............................................................................. 9
10 FEDERAL ADJUSTED GROSS INCOME. (See instructions on page 6 for line references
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to federal forms. If negative, enter a minus sign in the box to the left of the number.) ........... 10
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11 MAINE STATE RETIREMENT CONTRIBUTIONS. .................................................................. 11
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12 U.S. GOVERNMENT BOND INTEREST included in your federal adjusted gross income. .... 12
13 SOCIAL SECURITY AND RAILROAD RETIREMENT BENEFITS included in your federal
,
.
adjusted gross income. ............................................................................................................. 13
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.
14 PENSION INCOME DEDUCTION. (See instructions and worksheet on page 14) .................. 14
15 MAINE ADJUSTED GROSS INCOME. (Add lines 10 and 11, subtract lines 12, 13, and 14.
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.
If negative, enter a minus sign in the box to the left of the number) ........................................ 15
,
.
16 STANDARD DEDUCTION. (See instructions on page 7) .............................................................. 16
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17 EXEMPTION. (Multiply number of exemptions on line 9 by $2,850) ............................................. 17
18 TAXABLE INCOME. (Line 15 minus lines 16 and 17.
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If negative, enter a minus sign in the box to the left of the number.) ............................................. 18
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19 INCOME TAX. (Find the tax for the amount on line 18 in the tax table on pages 15-19) .............. 19
(If line 18 is negative, enter zero.)
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