Form 1040me - Maine Individual Income Tax - Long Form

*0402101*

2004

1040ME LONG FORM

Page 2

27 Amount from line 26. (NET TAX)

*0402101*

If less than zero, enter zero here. .... 27

28 TAX PAYMENTS.

Maine Income Tax Withheld. (Enclose W-2, 1099 and 1099ME forms). ....

28a

2004 Estimated Tax Payments and 2003 Credit Carried Forward.

(Nonresidents: Include any REAL ESTATE WITHHOLDING Tax Payments). ... 28b

Extension payment ........................................................................................ 28c

Refundable child care credit. Enclose the Child Care Credit Worksheet.

Enter amount from the Child Care Credit Worksheet, line 5 on page 22. ..... 28d

TOTAL (Add lines 28a, b, c, and d) ................................................................. 28e

29 OVERPAYMENT. If line 28e is larger than line 27, enter amount overpaid

(Line 28e minus line 27) ........................................................................................ 29

30 UNDERPAYMENT. If line 27 is larger than line 28e, enter amount underpaid

(Line 27 minus line 28e) ........................................................................................ 30

31 USE TAX (SALES TAX). (See Instructions.) ........................................................ 31

32 VOLUNTARY CONTRIBUTIONS and PARK PASSES. (From Schedule CP, line 12) ... 32

33 REFUND. (Line 29 minus lines 31 and 32) – NOTE: If total of lines 31 and 32

is greater than line 29, enter as amount due on line 35a below .......................... 33

☺

34 Amount to be CREDITED

REFUND

to 2005 estimated tax .. 34a

34b

IF YOU WOULD LIKE YOUR REFUND SENT DIRECTLY TO YOUR BANK ACCOUNT ($5,000 or less) OR TO YOUR NEXTGEN COLLEGE INVESTING PLAN ®

ACCOUNT, see the instructions on pages 7 and 8 and fill in the lines below. NOTE: Completing the information below authorizes Maine Revenue Services to

disclose your social security number, listed on the front of this form, to your financial institution for the sole purpose of depositing your income tax refund directly into your

bank account or NextGen College Investing Plan ® Account.

Direct

34e Type of Account:

Checking

34c Routing Number

Savings

Deposit

NextGen ®

34d Account Number*

*For NextGen Accounts, enter the Account Participant’s 9-digit social security number.

35 a TAX DUE. (Add lines 30, 31, and 32) - NOTE: If total of lines 31 and 32 is

greater than line 29, enter the difference as an amount due on line 35a ........ 35a

b Underpayment Penalty (Attach Form 2210ME)

Check here if you checked the box on Form 2210, line 17 .............

.......... 35b

c TOTAL AMOUNT DUE. (Add lines 35a and 35b) (Pay in full with return)

ENCLOSE CHECK payable to: Treasurer, State of Maine. Include your social security

number on your check to receive proper credit on your account. DO NOT SEND CASH

... 35c

FOR MAINE RESIDENTS ONLY: Check this box if you would like to receive a 2005 Maine Residents Property Tax and Rent Refund Application:

See instructions on page 8 for information about the Tax and Rent Program. THE APPLICATION WILL BE MAILED TO YOU

IN AUGUST 2005 unless your income on line 16 exceeds the income limits for this program.

To reduce printing and postage costs, if you file your return electronically or have your return done by a tax preparer and do not need Maine

income tax forms and instructions mailed to you next year, check box at right. ...........................................................................................................

If taxpayer is deceased,

If spouse is deceased,

IMPORTANT NOTE

enter date of death.

Third Party

Do you want to allow another person to discuss this return with Maine Revenue Services?

Yes (complete the following).

No.

Designee

Designee’s name _________________________

Phone no. (

) __________________

Personal identification #:

(See page 8)

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and

belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

SIGN

____________________________

______________

__________________

HERE

YOUR SIGNATURE

DATE SIGNED

YOUR OCCUPATION

Keep a

____________________________

______________

__________________