Form 481.0 - Individual Income Tax Return - 2012 printable pdf download

Form 481.0

Rev. Feb 5 13

SHORT FORM

Serial Number

RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)

2012

Reviewer

Liquidator

COMMONWEALTH OF PUERTO RICO

DEPARTMENT OF THE TREASURY

INDIVIDUAL INCOME TAX RETURN

AMENDED RETURN

2012

R G RO V1 V2 P1 P2 N D1 D2 E A

FOR CALENDAR YEAR

OR TAXABLE YEAR BEGINNING ON

DECEASED DURING THE YEAR: ______/______/______

Day

Month Year

__________________ , ___________ AND ENDING ON __________________ , ___________

TAXPAYER

SPOUSE

Taxpayer's Social Security Number

Taxpayer's Name

Initial

Last Name

Second Last Name

Receipt Stamp

Date of Birth

Sex

Postal Address

Day

Month

Year

Spouse's Social Security Number

Zip Code

Spouse's Date of Birth

Sex

"Place Label here".

Spouse's First Name and Initial

Last Name

Second Last Name

Day

Month

Year

Home Telephone

(

)

Home Address (Town or Urbanization, Number, Street)

Work Telephone

(

)

Zip Code

CHANGE OF ADDRESS:

Yes

2013 RETURN:

SPANISH

ENGLISH

E-Mail Address

YES NO

E. FILING STATUS AT THE END OF THE TAXABLE YEAR:

United States Citizen?

Married

Resident of Puerto Rico at the end of the year?

(Fill in here

if you choose the optional computation and go to Schedule CO

Other excluded or tax exempt income?

C .

Individual)

(Submit Schedule IE Individual)

Individual taxpayer

D. HIGHEST SOURCE OF INCOME:

(Fill in and submit spouse's name and social security number if you are:

Government, Municipalities or Public Corporations Employee

Federal Government Employee

Married with a complete separation of property prenuptial agreement

Married not living with spouse)

Private Business Employee

Retired/Pensioner

Married filing separately

Other ___________________

(Submit spouse's name and social security number above)

Your occupation

Spouse's occupation

GO TO PAGE 2 TO DETERMINE YOUR REFUND OR PAYMENT.

AMOUNT OVERPAID (Part 1, line 14. Indicate distribution on lines A, B and C) .....................................................................................

(01)

A) Contribution to the San Juan Bay Estuary Special Fund .............................................................................................................................

(02)

B) Contribution to the Special Fund for the University of Puerto Rico ............................................................................................................

(03)

C) TO BE REFUNDED (If you want your refund to be deposited directly into your account, complete the Deposit Part) ...........................

(04)

AMOUNT OF TAX DUE (Part 1, line 14) ....................................................................................................................................

(05)

Less: Amount paid

(a)

With Return or Electronic Transfer through a Certified Program ....................................................

(06)

(07)

(b)

Interest .........................................................................................................................

(c)

Surcharges _____________ and Penalties _____________ ..........................................

(08)

BALANCE OF TAX DUE (Subtract line 2 from line 3(a)) .....................................................................................................................................

(10)

AUTHORIZATION FOR DIRECT DEPOSIT OF REFUND

Type of account

Routing/transit number

Your account number

Checking

Savings

Account in the name of: ___________________________________________________________ and _______________________________________________________________

(Print complete name as it appears on your account. If married and filing jointly, include your spouse's name)

I hereby declare under penalty of perjury that I have examined the information included in this return, schedules and other documents attached to it, and it is true, correct and complete.

The declaration of the person that prepares this return (except the taxpayer) is based on the information available, and this information has been verified.

Spouse's Signature

Taxpayer's Signature

Date

Specialist's Name (Print)

Name of the Firm or Business

Date

Registration Number

Specialist's Signature

Self - employed Specialist

(fill in here)

NOTE TO TAXPAYER: Indicate if you made payments for the preparation of your return:

Yes