Form 511nr - State Of Oklahoma Income Tax Return

Nonresident

For Office Use Only

2002

511nr

Part-Year

Resident

For the year January 1 - December 31, 2002, or other taxable year beginning _____________, 2002 ending _____________, ______.

The due date for this form is the 15th day of the fourth month after the close of the taxable year.

Your Social Security Number

State of Oklahoma

Spouse’s Social Security Number

(joint return only)

Income Tax Return

Not Required to File...

Print first name and initial (If joint return, give first name and initial of both)

Last name

Check this box if you do not have an Oklahoma

filing requirement and are filing for refund of

Type

Present home address (number and street, including apartment number or rural route)

your state withholding. (see instructions)

Regular Special

Blind

City, State and Zip

Yourself

Add the

Totals from

1 _____ Single

the 4 shaded

Filing

Spouse

boxes.

2 _____ Married filing joint return (even if only one had income)

Status

3 _____ Married filing separate. If spouse is also filing,

Write the

Number of dependent children

Total in the

give SSN and name here: ___________________________

box below.

4 _____ Head of household with qualifying person

Number of other dependents

5 _____ Qualifying widow(er) with dependent child

Total

Please list year spouse died here: ____________________

Please Note:

If you may be claimed as a dependent on another

Nonresident(s) State of Residence: ______________________

Residency

return, enter “0” for your regular exemption.

Status

Part-Year Resident(s) From _____________ to _____________

65 or Over?

Resident/Part-Year Resident/Nonresident

(See Instructions

Yourself

Spouse

State of Residence: Husband ___________ Wife___________

on page 5 of packet)

Please Round to Nearest Whole Dollar

Start Here:

To Arrive at Oklahoma Adjusted Gross Income.

Lines 1-19: In the Federal column, enter the amounts from your Federal Tax Return.

Federal Amount

Oklahoma Amount

See the instructions to figure the amounts to report in the Oklahoma column.

Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dividend income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxable refunds (state income tax) . . . . . . . . . . . . . . . . . . . . . . .

Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Business income or (loss) (Federal Schedule C) . . . . . . . . . . . .

Capital gains or losses (Federal Schedule D) . . . . . . . . . . . . . . .

Other gains or losses (Federal Form 4797) . . . . . . . . . . . . . . . .

Taxable IRA distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxable pensions and annuities . . . . . . . . . . . . . . . . . . . . . . . . .

Rental real estate, royalties, partnerships, etc. . . . . . . . . . . . . . .

Farm income (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxable Social Security benefits

. .

(also enter on line 2 of Sch. 511NR-B)

Other income (identify: ______________________________ )

Add lines 1 through 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Federal adjustments to income (identify: ____________ )

Oklahoma source income (line 16 minus line 17) . . . . . . . . . .

Federal adjusted gross income (line 16 minus line 17) . . . . .

Oklahoma additions: Total from Schedule 511NR-A, line 7 . . .

Add lines (Federal 19 & 20) and then (Oklahoma 18 & 20) . . .

Oklahoma subtractions: Total from Schedule 511NR-B, line 12

Adjusted gross income: Okla. Source (line 21 minus line 22) . . .

Adjusted gross income: All Sources

(line 21 minus line 22)

Also enter on line 25

Form 511nr - State Of Oklahoma Income Tax Return - 2002

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