Form 481.0 - Individual Income Tax Return - 2003
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3Ovals must be filled in completely. Example
Form 481.0
Rev. 05.03
RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)
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SHORT FORM
Serial Number
COMMONWEALTH OF PUERTO RICO
2003
2003
DEPARTMENT OF THE TREASURY
Reviewer
Liquidator
INDIVIDUAL INCOME TAX RETURN
R M
V1 V2 P1 P2 N D E
A
G
FOR CALENDAR YEAR 2003 OR TAXABLE YEAR BEGINNING ON
RETURN:
AMENDED
DECEASED DURING THE YEAR
_______________, _______ AND ENDING ON ______________, _______
Spouse's Social Security Number
Sex
Social Security Number
Payment Stamp
M
F
Taxpayer's Date of Birth
First Name
Initial
Last Name
Second Last Name
Day
Month
Year
Spouse's Date of Birth
Postal Address
Day
Month
Year
Change of Address
Zip Code
Yes
No
"Place Label here".
2004 Return
Spouse's First Name
Initial
Last Name
Second Last Name
Spanish
English
Home Telephone
Receipt Number:
Home Address (Town or Urbanization, Number, Street)
Amount:
Office Telephone
E-Mail Address
Zip Code
Part 1
YES
NO
HIGHEST SOURCE OF INCOME:
OCUPATION:
Taxpayer
a.
¿United States Citizen?
g.
Government, Municipalities and
b.
¿Resident of Puerto Rico at the end of the year?
Public Corporations Employee
Spouse
c.
¿Tax exempt income from the Lottery of Puerto Rico?
h.
Federal Government Employee
d.
¿Income from racetrack winnings in Puerto Rico?
Private Business Employee
i.
Receipt Stamp
e.
¿Other exempt income?
Retired/Pensioner
j.
f.
¿Obligation to make payments to ASUME?
FILING STATUS AT THE END OF THE TAXABLE YEAR:
Married living with spouse and filing jointly
3.
Head of household (Not married)
1.
Married not living with spouse (Not head of household)
4.
Single
2.
(Submit spouse's name and social security number)
Part 2
B-Wages, Commissions, Allowances
Wages, Commissions, Allowances and Tips
A-Income Tax Withheld
1.
and Tips
ATTACH ALL YOUR WITHHOLDING STATEMENTS
(Forms 499R-2/W-2PR, 499R-2c/W-2cPR or W-2,
.
0
0
.
0
0
,
,
as applicable).
00
.
.
0
0
0
0
,
,
.
0
0
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0
0
,
,
.
.
0
0
0
0
,
,
.
0
0
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0
0
01
,
,
Total (No. of withholding statements with this return) ...............
Federal Wages
Income Tax Withheld
Federal Government Wages (See instructions) ...................................
2.
.
0
0
.
(01)
0
0
,
,
(02)
Income from Annuities and Pensions (Schedule H Individual, Part II, line 12) ......................................................
3.
.
0
0
(03)
,
Ajusted Gross Income (Add lines 1B, 2B and 3) ......................................................................................................
4.
(10)
.
0
0
,
Conservation Period: Ten (10) Years
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