1040me Long Form - Maine Individual Income Tax

*0302102*

SCHEDULES 1 & 2

See instructions on pages 9 and 10.

Attachment

Enclose with your Form 1040ME

Sequence No.

*0302102*

Name(s) as shown on Form 1040ME

Your Social Security Number

SCHEDULE 1 — INCOME MODIFICATIONS

1 ADDITIONS to federal adjusted gross income.

a Income from municipal and state bonds, other than Maine ............................................................ 1a

b Net Operating Loss Recovery Adjustment (Attach a schedule showing your calculation) ............. 1b

c Maine State Retirement Contributions ............................................................................................ 1c

d Fiduciary Adjustment - additions only (Attach a copy of your federal Schedule K-1) ..................... 1d

e Bonus Depreciation and Section 179 Add-back (See instructions) ................................................ 1e

Other (See instructions). List the type and amount of income items included (attach supporting

documentation) ___________________________________________________________ ..... 1f

g Total additions (Add lines 1a through 1f) ........................................................................................ 1g

2 SUBTRACTIONS from federal adjusted gross income.

a U.S. Government Bond interest included in federal adjusted gross income .................................. 2a

b State Income Tax Refund (Only if included in federal income) ....................................................... 2b

c Social Security and Railroad Retirement Benefits included in federal adjusted gross income

(See instructions) ............................................................................................................................ 2c

d Pension Income Deduction (Complete and attach the worksheet on back) ................................... 2d

e Interest from Maine Municipal General Obligation Bonds included in federal adjusted gross income ..... 2e

Premiums for Long-Term Care Insurance (Do not include health insurance premiums on this line)

(See instructions). NOTE: If you itemize deductions, complete and attach worksheet on back ... 2f

g Maine State Retirement System Pick-Up Contributions paid to the taxpayer during 2003

which have been previously taxed by the state .............................................................................. 2g

h Federal Work Opportunity Credit .................................................................................................... 2h

Fiduciary Adjustment-deductions only (Attach a copy of your federal Schedule K-1) ............... 2i

Other. List _______________________________ (See instructions) ......................................... 2j

(Nonresidents and Part-year residents - Do not enter non-Maine income)

k Total Subtractions (Add lines 2a through 2j) ................................................................................... 2k

3 Net Modification (Subtract line 2k from line 1g — enter here and on 1040ME, page 1, line 15

[May be a negative amount]) ................................................................................................................ 3

SCHEDULE 2 — ITEMIZED DEDUCTIONS

4 Total itemized deductions from federal Form 1040, Schedule A, line 28 ............................................. 4

5 a Income taxes imposed by this state or any other taxing jurisdiction included in line 4 above

from federal Form 1040, Schedule A, line 5. (See instructions if Form 1040ME, line 14 exceeds

$139,500 [$69,750 if Married Filing Separately]) ............................................................................ 5a

b Deductible costs, included in line 4 above, incurred in the production of Maine exempt income

(See instructions) ............................................................................................................................ 5b

c Amounts included in line 4 that are also being claimed for the Family Development Account

Credit on Maine Schedule A, line 23 ............................................................................................... 5c

d Amount included in line 4 attributable to income from an ownership interest in a flow-through

entity financial institution ................................................................................................................. 5d

6 Deductible costs of producing income exempt from federal income tax, but taxable by Maine

(See instructions) ................................................................................................................................. 6

7 Line 4 minus lines 5a, b, c, and d plus line 6. Enter result here and on 1040ME, page 1, line 17 ...... 7

Note: If the amount on line 7 is less than your allowable standard deduction, use the standard deduction.

If Married Filing Separately, however, both spouses must either itemize or use the standard deduction.

1040me Long Form - Maine Individual Income Tax - 2003 Page 3

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