Form 40n - Oregon Individual Income Tax Return - 2002 Page 2
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1
2Page 2 — 2002 Form 40N
Federal column
Oregon column
36 Amount from front of form, line 35 .......................................................................
36
SUBTRACTIONS
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37 Social Security and tier 1 railroad retirement income included on line 19 ..........
37
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38 Other subtractions. Identify ________________________________________
38a
38b
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39 Income after subtractions. Line 36 minus lines 37 and 38 ...................................
39a
39b
40 Oregon percentage. Line 39b ÷ line 39a (not more than 100%) ......
__ __ __.__ %
40
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DEDUCTIONS
41 Itemized deductions from federal Schedule A, line 28 .........................................
41
AND
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42 State income tax claimed as itemized deduction. See instructions, page 23 .........
42
MODIFICATIONS
EITHER,
43 Net Oregon itemized deductions. Line 41 minus line 42 ........................................
43
NOT BOTH
44 Standard deduction from page 23 .........................................................................
44
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45 2002 federal tax ($0–$3,250; see instructions for the correct amount) ..................
45
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46 Other deductions and modifications. Identify ___________________________
46
47 Add lines 44, 45, and 46 or lines 43, 45, and 46. Fill in the larger amount ..........
47
48 Allowable deductions and modifications. Line 47
line 40 ....................................
48
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49 Deductions and modifications
NOT multiplied by the Oregon percentage. See page 25 ...
49
50 Total deductions and other modifications. Add lines 48 and 49 ......................................................................
50
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51 Oregon taxable income. Line 39b minus line 50 ..................................................
.......................................
51
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OREGON
EITHER,
52 Tax from tax rate charts (see instructions, page 25) ............................................
52
TAX
NOT BOTH
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53 Or, check if from:
Form FIA-40N or
Worksheet FCG and enter tax here ......
53
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54 Interest on certain installment sales ....................................
54
55 Total tax. Add lines 52 and 54 OR add lines 53 and 54 ..................................................... OREGON TAX
55
CREDITS
56 Exemption credit. Line 6e
$145
Oregon percentage from line 40 .................
56
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57 Earned income credit. See instructions, page 26 ................................................
57
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58 Working family child care credit. See instructions, page 26 ..................................
58
ADD TOGETHER
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59 Credit for income taxes paid to another state (AZ, CA, IN, VA). Attach proof ........
59
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60 Child and dependent care credit. See instructions, page 26 .................................
60
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61 Other credits. Identify_______________________________________________
61
62 Total credits. Add lines 56 through 61 ..............................................................................................................
62
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63 Net income tax. Line 55 minus line 62. If line 62 is more than line 55, fill in -0- .....
.......................................
63
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TAX
64 Oregon income tax withheld from income. Attach Forms W-2 and 1099 ............
64
ADD TOGETHER
PAYMENTS,
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65 Estimated tax payments for 2002 and payments made with your extension .........
65
PENALTY,
66 Total payments. Add lines 64 and 65 ................................................................................................................
AND
66
INTEREST
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67
Overpayment.
Is line 63 less than line 66? If so, line 66 minus line 63 ................
....
OVERPAYMENT
67
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TAX TO PAY
68
Tax to pay.
Is line 63 more than line 66? If so, line 63 minus line 66 ...................
..........
68
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69 Penalty and interest for filing or paying late. See instructions, page 27 .................
69
ADD TOGETHER
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70 Interest on estimated tax underpayment.
Attach Form 10 and check here
...
70
71 Total penalty and interest due. Add lines 69 and 70 .........................................................................................
71
72
Amount you owe.
Line 68 plus line 71 .....................................................................
AMOUNT YOU OWE
72
REFUND
73
Refund.
Is line 67 more than line 71? If so, line 67 minus line 71 ................................................
73
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74
Estimated tax.
Fill in the part of line 73 you want applied to 2003 estimated tax ....
74
CHARITABLE
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75 Oregon Nongame Wildlife ..............
$1 ...
$5 ...
$10 ...
75
Other $_____
CHECKOFFS
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76 Child Abuse Prevention ..................
$1 ...
$5 ...
$10 ...
76
Other $_____
These will
I wish to
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donate
77 Alzheimer’s Disease Research .......
$1 ...
$5 ...
$10 ...
reduce
77
Other $_____
part of my
your refund
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78 Stop Domestic & Sexual Violence ..
$1 ...
$5 ...
$10 ...
78
Other $_____
tax refund
to the
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79 AIDS/HIV Education and Services ..
$1 ...
$5 ...
$10 ...
79
Other $_____
following
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80 Other charity. Enter code
____ ....
$1 ...
$5 ...
$10 ...
80
fund(s)
Other $_____
81 Total. Add lines 74 through 80. Total can’t be more than your refund on line 73 ..............................................
81
82
NET REFUND.
Line 73 minus line 81. This is your net refund ............................................
NET REFUND
82
DIRECT
83 For direct deposit of your refund, see the instructions on page 28.
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Type of Account:
Checking or
Savings
DEPOSIT
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Routing No.
Account No.
Attach a copy of your federal Form 1040, 1040A, 1040EZ, 1040NR, or TeleFile Tax Record. Do not attach other federal schedules.
Under penalties for false swearing, I declare that I have examined this return, including accompanying schedules and statements. To the
I authorize the Department of Revenue
best of my knowledge and belief it is true, correct, and complete. If prepared by a person other than the taxpayer, this declaration is based
to discuss this return with
on all information of which the preparer has any knowledge.
this preparer.
Yes
No
Your signature
Date
License No.
Signature of preparer other than taxpayer
X
X
SIGN
HERE
Telephone No.
Spouse’s signature
Date
Address
(if filing jointly, BOTH must sign)
X
150-101-048 (Rev. 12-02)
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