Form 481.0 - Individual Income Tax Return - 2011 (Page 2 of 2) in pdf

Rev. Feb 13 12

Form 481.0 - Page 2

If you choose the optional computation of tax for married individuals living together, do not complete lines 1 through 11 of Part 1, and go to Schedule CO Individual.

B-Wages, Commissions,

Wages, Commissions, Allowances and Tips

A-Income Tax Withheld

Allowances and Tips

ATTACH ALL YOUR WITHHOLDING STATEMENTS

(Forms 499R-2/W-2PR, 499R-2c/W-2cPR or W-2, as applicable).

Total of withholding statements with this return .......................................................

Total ...................................................................................................................................

(01)

(03)

Federal Government Wages (See instructions)

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

(02)

(04)

Income from annuities and pensions (Schedule H Individual, Part II, line 12) ...............................................................................................

(05)

Adjusted Gross Income (Add lines 1B, 2B and 3B) ....................................................................................................................

(06)

TOTAL DEDUCTIONS (Schedule A Individual, Part I, line 11) ...............................................................................................................

(01)

Additional Personal Exemption for Veterans (See instructions) .......................................................................................................

(02)

PERSONAL EXEMPTION (Married - $7,000; Individual taxpayer - $3,500; Married filing separately - $3,500) ...............................................

(03)

EXEMPTION FOR DEPENDENTS (Complete Part 2, see instructions) .....................

__________ X $2,500 ..

(06)

(04)

__________ X $1,250 ..

(07)

(05)

Total Exemption for Dependents (Add lines 8A and 8B) .....................................................................................................................

(08)

SPECIAL DEDUCTION FOR CERTAIN INDIVIDUALS (See instructions) .............................................................................................

(09)

10.

Total Deductions and Exemptions (Add lines 5 through 9) .....................................................................................................................

(10)

11.

NET TAXABLE INCOME (Subtract line 10 from line 4. If line 10 is larger than line 4, enter zero) .............................................

(11)

12.

TAX DETERMINED (Use the amount of line 11 and the Tax Table, as applicable. See instructions) ..................................................................

(12)

13.

TAX WITHHELD, REIMBURSABLE CREDITS AND AMOUNT PAID:

A) Tax withheld on wages (Add lines 1A and 2A or lines 1A and 2A of Schedule CO Individual) .............................

(13)

(16)

B) Tax withheld on annuities and pensions (Schedule H Individual, Part II, line 13) ...............................................

(14)

C) Employment Credit (See instructions) .......................................................................................................

(15)

(17)

D) Credit for persons age 65 or older (See instructions) ....................................................................................

(16)

E) Compensatory credit for low income pensioners (See instructions) ................................................................

(17)

F) Credit for the payment of additional duties on luxury vehicles under Act 42-2005 (See

instructions) (Taxpayer: ____________________

Spouse:__________________

) ...................................

(18) ;

(19)

(20)

G) American Opportunity Tax Credit (Submit Schedule B2 Individual) .................................................................

(21)

H) Amount paid with automatic extension of time ........................................................................................................

(22)

(23)

I) Total Tax Withheld, Reimbursable Credits and Amount Paid (Add lines 13A through 13H) .......................................................................

14.

BALANCE:

If line 13 I is larger than line 12, you have an overpayment. Enter the difference here and on line 1 of page 1.

If line 13 I is smaller than line 12, you have a balance of tax due. Enter the difference here and on line 2 of page 1.

If the difference between line 13 I and line 12 is equal to zero, enter zero here and sign your return on page 1 ..............................

(30)

Dependent's Information (See instructions)

Relationship

Joint

Name, Initial

Last

Second