Form 40 - Oregon Individual Income Tax Return - 1999

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Form
Oregon
1999
0
4
Individual
Income Tax
FULL-YEAR
Return
For office use only
RESIDENTS ONLY
Fiscal year ending
Date received
Last name
First name and initial
Birth Year
Enter your Social Security No. (SSN)
Remember
Spouse’s last name if different and joint return
Spouse’s first name and initial if joint return
Spouse’s
Enter Spouse’s SSN, if joint return
to write
Birth Year
in your
Current mailing address
Telephone number
Social
(
)
Security No.
City
State
ZIP Code
If you filed a return in 1998, and this
address is different, check here
1
Single
Severely
Filing
Exemptions
Regular
Total
disabled
2
Married filing jointly
Status
6a Yourself
6a
3
Married filing separately
(Spouse’s name)
Check
6b Spouse
b
only one
c
6c All dependents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
box
(Spouse’s Social Security number)
d
6d Disabled
4
Head of household
(First names)
children only
(Person who qualifies you)
Total
6e
5
Qualifying widow(er) with dependent child
1
2
3
For office
7 Check if: You were:
65 or older
Blind
Check if you filed an extension
use only
Spouse was:
65 or older
Blind
Attach a Copy of Your Federal Form 1040, 1040A, 1040EZ, 1040PC. Do not attach federal schedules A, B, C, Form 2441, etc.
8 Federal adjusted gross income. Federal Form 1040, line 33,
federal Form 1040A, line 18 or federal Form 1040EZ, line 4; Telefile Tax Record, line I . . . . . . . . . . . . . . . . . . .
8
ADDITIONS
9 Interest on government bonds of other states . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
10 Other additions. Identify ______________________________________________ . . .
10
11 Total additions. Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
12 Income after additions. Add lines 8 and 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
SUBTRACTIONS
13 1999 federal tax liability ($0 - $3,000, see instructions for the correct amount) . . . . . . . .
13
14 Social Security included on federal Form 1040, line 20b or Form 1040A, line 13b . . . . .
14
15 Oregon income tax refund included in federal income . . . . . . . . . . . . . . . . . . . . . . . . . .
15
16 Interest from U.S. government, such as Series EE and HH bonds . . . . . . . . . . . . . . . . .
16
17 Federal pension income (see instructions on page 26) . . . . . . . . . . . . . . . . . . . . . . . . . .
17
18 Other subtractions. Identify ____________________________________________ . . .
18
19 Total subtractions. Add lines 13 through 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
20 Income after subtractions. Line 12 minus line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
DEDUCTIONS Fill in lines 21 through 25 or line 26 only
21 Itemized deductions from Schedule A, line 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
22 Special Oregon medical deduction (you or your spouse must be at least age 62) . . . . . .
22
23 Total Oregon itemized deductions. Add lines 21 and 22 . . . . . . . . . . . . . . . . . . . . . . . . .
23
24 State income tax claimed as an itemized deduction from Schedule A, line 5. . . . . . . . . . .
24
25 Net Oregon itemized deductions. Line 23 minus line 24 . . . . . . . . . . . . . . . . . . . . . . . . .
25
(Either line 25 or 26)
26 Standard deduction from page 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
27 Total deductions. Line 25 or line 26, whichever is larger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
28 Oregon taxable income. Line 20 minus line 27. If line 27 is more than line 20, fill in -0- . . . . . . . . . . . . . . . . . .
28
NOW GO TO THE BACK OF THE FORM
150-101-040 (Rev. 9-99)

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