1040me Long Form - Maine Individual Income Tax - 2011

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2011
L
MAINE INDIVIDUAL INCOME TAX
1040ME LONG FORM
99
For tax period
2 0 1 1
/
/
to
/
/
*1102100*
1/1/2011 to 12/31/2011 or
See instructions on pages 2 and 3. Print neatly in blue or black ink only.
Your First Name
MI
IMPORTANT!
You must enter your SSN(s) below.
Your Last Name
Your Social Security Number
Spouse’s First Name
MI
-
-
Spouse’s Social Security Number
-
-
Spouse’s Last Name
Home Phone Number
Mailing Address (PO Box, number, street and apt. no)
-
-
Work Phone Number
-
-
City
State
Zip Code
NOTE: If either spouse is deceased, enter the date of death on the back of this page in the spaces provided above the signature area.
1
Maine Clean Election Fund. Maine Residents Only. Check here if you, or
2 Check here if you were engaged in COMMERCIAL
your spouse, if fi ling jointly, want $3 to go to this fund.
You
Spouse
FARMING OR FISHING during 2011 .....................
FILING STATUS (Check one)
RESIDENCY STATUS (Check one)
12 CHECK IF:
You
Spouse
were
was
3
Single
8
Resident
4
Married fi ling joint return (Even if only one had income)
8a
“Safe Harbor” Resident
65 or over ............ 12a
12c
5
Married fi ling separate return. Enter spouse’s social
9
Part-Year Resident
security number and full name above.
Blind..................... 12b
12d
6
Head of household (With qualifying person)
10
Nonresident
7
Qualifying widow(er) with dependent child
11
Nonresident Alien
(Year spouse died
)
13 Enter the TOTAL number of
Check here if you are
EXEMPTIONS claimed
fi ling Schedule NRH
on your federal return ....13
Composite Return (Pass-through Entities ONLY)
,
,
.00
14
FEDERAL ADJUSTED GROSS INCOME. ..........................................................................14
,
,
.00
15
INCOME MODIFICATIONS. (From Schedule 1, line 3.) .....................................................15
,
,
.00
16
MAINE ADJUSTED GROSS INCOME. (Line 14 plus or minus line 15. .............................16
,
,
.00
17
DEDUCTION.
Standard (See instructions on page 2) ............................................ 17
Itemized (From Schedule 2, line 7)
,
.00
18
EXEMPTION. Multiply the number of exemptions on line 13 by $2,850. (See instructions.) .......................... 18
,
,
.00
19
TAXABLE INCOME. (Line 16 minus lines 17 and 18.) ...................................................... 19
20
INCOME TAX. (Find the tax for the amount on line 19 in the tax table on pages 15-16 or
,
,
.00
compute your tax using the tax rate schedules at
)
........... 20
,
,
.00
21
TAX ADDITIONS. (From Maine Schedule A, line 4.) ......................................................... 21
22
LOW-INCOME TAX CREDIT. (See instructions.)
NOTE: You must fi le a return only
,
,
.00
if you are claiming a
refund.) .............................................................................................. 22
,
,
.00
23
TOTAL TAX. (Line 20 plus line 21 minus line 22) ............................................................... 23
,
,
.00
24
TAX CREDITS. (From Maine Schedule A, line 21) ............................................................. 24
25
NONRESIDENT CREDIT. (For part-year residents, nonresidents and
,
,
.00
“Safe Harbor” residents only.) From Schedule NR, line 9 or NRH, line 11 ......................... 25
(You MUST attach a copy of your federal return and/or TDY papers.)
,
,
.00
26
NET TAX. (Subtract lines 24 and 25 from line 23) (Nonresidents see instructions) ................ 26

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