Schedule H Individual - Income From Annuities Or Pensions - 2003
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1Schedule H Individual
E
H
0
3
0
0
Rev. 05.03
2003
INCOME FROM ANNUITIES OR PENSIONS
Taxable year beginning on __________________________________ , ________ and ending on ____________________________________ , ________
Social Security Number
Taxpayer's name
Recipient of pension (fill in one):
1 Taxpayer
2 Spouse
35
Place where the service was performed:
Puerto Rico
United States
Others ____________________
1
2
Federal
ELA
Private Business Employer
3
Pension granted by (fill in one):
Date in which you began receiving the pension:
Day
Month
Year
Part I:
Determination of Cost to be Recovered (See instructions)
1.
Cost of annuity (amount paid). If it is zero, go to Part II and enter zero on line 10 ..................................................
.
(01)
0
0
,
2.
Pension received in previous years:
Year:
_______
_______
_______
_______
_______
Amount:
_______
_______
_______
_______
_______
..................................................
(02)
.
0
0
,
3.
Less:
(a) Taxable pension received in previous years:
Year:
_______
_______
_______
_______
_______
.
Amount:
_______
_______
_______
_______
_______
0
0
(03)
,
(b) Tax exempt pension received in previous years:
Year:
_______
_______ _______
_______
_______
.
0
0
Amount:
_______
_______ _______ _______
_______
,
(04)
4.
Total (Add lines 3(a) and 3(b)) ..............................................................................................................................
.
0
0
(05)
,
5.
Cost of pension tax exempt recovered in previous years (Subtract line 4 from line 2) ...........................................
(06)
.
0
0
,
.
6.
0
0
Cost to be recovered (Subtract line 5 from line 1) ..................................................................................................
(07)
,
Part II:
Taxable Income (See instructions)
7.
Total amount received in the year ..........................................................................................................................
(08)
.
0
0
,
8.
Tax exempt amount ...............................................................................................................................
.
0
0
(09)
,
9.
Pension income less the exempt amount (Subtract line 8 from line 7. If it is less than zero, go to
line 13)
.................................................................................................................................................
.
(10)
0
0
,
10.
Cost to be recovered (Same as line 6)
.................................................................................................................
(11)
.
0
0
,
11.
Pension income in excess of the cost to be recovered (Subtract line 10 from line 9) ..............................................
(12)
.
0
0
,
12.
Taxable pension income (Enter here the amount of line 11 or 3% of line 1, whichever is larger
(but not larger than the amount of line 9). Enter this amount in Part 2,
line 3 of the Short Form) ........................................................................................................................................
(13)
.
0
0
,
13.
Tax withheld on annuity or pension for the taxable year (Enter this amount in Part 4,
line 15B of the Short Form) ...................................................................................................................................
.
0
0
(14)
,
Conservation Period: Ten (10) Years
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