Form N-15 - Individual Income Tax Return Nonresident And Part-Year Resident - 1999 Page 2
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2FORM N-15 (REV. 1999)
PAGE 2
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34 Hawaii adjusted gross income from line 33, Column B .......................................................................................
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35 Ratio of Hawaii AGI to Total AGI. Divide line 33, Column B, by line 33, Column A
35
(Compute to 3 decimal places and round to 2 decimal places)
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CAUTION: If you can be claimed as a dependent on another person’s return, check here
and see Instructions.
36 If you do not itemize deductions, enter zero on line 36g and go to line 37a. Otherwise go to page 19 of the
Instructions and enter your Hawaii itemized deductions here.
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36a Medical and dental expenses (from Worksheet A-1) ..................................................
36a
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36b Taxes (from Worksheet A-2) .....................................................................................
36b
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36c Interest expense (from Worksheet A-3) .....................................................................
36c
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36d Contributions (from Worksheet A-4) ..........................................................................
36d
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36e Casualty and theft losses (from Worksheet A-5) ........................................................
36e
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36f Miscellaneous deductions (from Worksheet A-6) .......................................................
36f
36g If line 34 is more than $100,000 ($50,000 for married filing separately), see the worksheet on page 36 of the
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Instructions. If not, add lines 36a through 36f. Enter total here and go to line 38 ..... Total Itemized Deductions
36g
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37a If you checked filing status box:
1, enter $1,500
3, enter $950
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2 or 5, enter $1,900
4, enter $1,650
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37a
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37b Multiply line 37a by the ratio on line 35............................................................... Prorated Standard Deduction
37b
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38 Line 34 minus line 36g or 37b, whichever applies. (This line MUST be filled in) .......................................................
38
39a Multiply $1,040 by the total number of exemptions claimed on line 6e. If you and/or your spouse are blind,
deaf, or disabled, check applicable box(es) • Yourself •
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Spouse, and see page 24 of the Instructions 39a
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39b Multiply line 39a by the ratio on line 35...........................................................................Prorated Exemption(s)
39b
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40 Taxable Income. Line 38 minus line 39b (but not less than zero) ........................................... Taxable Income
40
41 Tax. Check if from
Tax Table;
Tax Rate Schedule;
Form N-168;
Form N-615; or
Capital Gains Tax Worksheet on
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page 36 of the Instructions. Net capital gain from line 14 of Capital Gains Tax Worksheet
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Include separate tax from Forms N-2, N-103, N-152, N-312, N-405, N-586, or N-814)........................ Tax
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42 Income tax paid to another state or to a foreign country (from Worksheet on page 36 of the Instructions) ..
42
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43 Energy Conservation Tax Credit (attach Form N-157)................................................
43
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44 Enterprise Zone Tax Credit (attach Form N-756) .......................................................
44
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45 Low-Income Housing Tax Credit (attach Form N-586) ..............................................
45
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46 Credit for Employment of Vocational Rehabilitation Referrals (attach Form N-884) ....
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47 Tax Credits for High-Technology (attach Form N-318) ...............................................
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48 Add lines 42 through 47 ......................................................................................Total Non-Refundable Credits
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49 Line 41 minus line 48 (but not less than zero) ........................................................................................ Balance
49
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50 Hawaii State Income tax withheld and tax withheld on IHA distribution .......................
50
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51 1999 estimated tax payments on Forms N-1 _________ ; N-4 _________ ; N-288A _________ ..........
51
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52 Amount of estimated tax applied from 1998 return.....................................................
52
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53 Amount paid with extension(s) ..................................................................................
53
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54 Low-Income Refundable Tax Credit (attach Schedule X) DHS, etc. exemptions
54
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55 Credit for Low-Income Household Renters (attach Schedule X) .................................
55
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56 Credit for Child and Dependent Care Expenses (attach Schedule X)..........................
56
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57 Credit for Child Passenger Restraint System(s) (attach a copy of the invoice) .....................
57
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58 Capital Goods Excise Tax Credit (attach Form N-312)...............................................
58
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59 Fuel Tax Credit for Commercial Fishers (attach Form N-163).....................................
59
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60 Motion Picture and Film Production Income Tax Credit (attach Form N-316) ..............
60
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61 Other credits (attach list and see page 27 of Instructions)...........................................
61
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62 Add lines 50 through 61 ......................................................................................... Total Payments and Credits
62
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63 If line 62 is larger than line 49, enter the amount OVERPAID (line 62 minus line 49) ...............................................
63
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64 Amount of line 63 to be REFUNDED TO YOU ..........................................................................................Refund
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65 Amount of line 63 to be applied to your 2000 ESTIMATED TAX ...............................
65
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66 If line 49 is larger than line 62, enter the AMOUNT YOU OWE (line 49 minus line 62). Attach check or money order for full amount payable
to “Hawaii State Tax Collector.” Write your social security number and “1999 Form N-15” on it. If you are filing your return late,
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see page 28 of the Instructions. .................................................................................................................Balance Due
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67 Estimated tax penalty. (See page 28 of Instructions.) Also include this amount in
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line 63 or 66, whichever applies. Check box if Form N-210 is attached
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67
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68 If you would like us to mail you a packet of forms for next year’s filing, please check this box ..................................
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DECLARATION
I declare, under the penalties set forth in section 231-36, HRS, that this return (including accompanying schedules or statements) has been examined by me and, to the best of my knowledge and belief, is a true,
correct, and complete return, made in good faith, for the taxable year stated, pursuant to the Hawaii Income Tax Law, Chapter 235, HRS.
Your signature
Date
Spouse’s signature (if filing jointly, BOTH must sign)
Date
Preparer’s Signature
Preparer’s identification number
Check if
Paid
self-employed
and date
Preparer’s
Firm’s name (or yours
Federal E.I. No.
Information
if self-employed) and
ZIP Code
address
FORM N-15
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