Form 40p - Oregon Individual Income Tax Return For Part-Year Residents - 2015 Page 2
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42015 Form 40P
Name
SSN
00611501020000
Federal column (F)
Oregon column (S)
Income
7 Wages, salaries, and other pay for work. Include all
•
.00
.00
Forms W-2 .............................................................................. 7F
7S
•
.00
.00
8 Taxable interest income from federal Form 1040, line 8a ....... 8F
8S
•
.00
.00
9 Dividend income from federal Form 1040, line 9a .................. 9F
9S
10 State and local income tax refunds from federal
•
.00
.00
Form 1040, line 10 ................................................................... 10F
10S
•
.00
.00
11 Alimony received from federal Form 1040, line 11 .................. 11F
11S
•
.00
.00
12 Business income or loss from federal Form 1040, line 12 ...... 12F
12S
•
.00
.00
13 Capital gain or loss from federal Form 1040, line 13 .............. 13F
13S
•
.00
.00
14 Other gains or losses from federal Form 1040, line 14 ........... 14F
14S
•
.00
.00
15 IRA distributions from federal Form 1040, line 15b ................. 15F
15S
•
.00
.00
16 Pension and annuities from federal Form 1040, line 16b ........ 16F
16S
•
.00
.00
17 Schedule E income from federal Form 1040, line 17 .............. 17F
17S
•
.00
.00
18 Farm income or loss from federal Form 1040, line 18 ............ 18F
18S
19 Unemployment and other income from federal Form 1040,
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.00
.00
lines 19 through 21 .................................................................. 19F
19S
•
•
.00
.00
20 Total income. Add lines 7 through 19 ...................................
20F
20S
Adjustments
21 IRA or SEP and SIMPLE contributions, federal Form 1040,
•
•
.00
.00
lines 28 and 32 .....................................................................
21F
21S
22 Education deductions from federal Form 1040,
•
•
.00
.00
line 23, 33, and 34 ................................................................
22F
22S
•
•
.00
.00
23 Moving expenses from federal Form 1040, line 26 ..............
23F
23S
24 Deduction for self-employment tax from federal
•
•
.00
.00
Form 1040, line 27 ................................................................
24F
24S
25 Self-employed health insurance deduction from federal
•
•
.00
.00
Form 1040, line 29 ................................................................
25F
25S
•
•
.00
.00
26 Alimony paid from federal Form 1040, line 31a ...................
26F
26S
•
•
.00
.00
27 Total adjustments from Schedule OR-ASC-N/P, section 1 ..
27F
27S
•
•
.00
.00
28 Total adjustments. Add lines 21 through 27 .........................
28F
28S
•
•
.00
.00
29 Income after adjustments. Line 20 minus line 28 .................
29F
29S
•
•
.00
.00
Additions
30 Total additions from Schedule OR-ASC-N/P, section 2 .......
30F
30S
•
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.00
.00
31 Income after additions. Add lines 29 and 30........................
31F
31S
Subtractions
32 Social Security and tier 1 Railroad Retirement Board
•
.00
benefits included on line 19F ...............................................
32F
•
•
.00
.00
33 Other subtractions from Schedule OR-ASC-N/P, section 3 .
33F
33S
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.00
.00
34 Income after subtractions. Line 31 minus lines 32 and 33 ...
34F
34S
•
.
35 __ __ __
__ %
35 Oregon percentage. Line 34S ÷ line 34F (not more than 100.0%) .........
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.00
Deductions
36 Amount from line 34F .....................................................................................................................
36
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.00
and
37 Itemized deductions from federal Schedule A, line 29 ...................................................................
37
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.00
modifications
38 State income tax claimed as itemized deduction ..........................................................................
38
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.00
39 Net Oregon itemized deductions. Line 37 minus line 38................................................................
39
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.00
40 Standard deduction ........................................................................................................................
40
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•
•
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40a You were:
65 or older;
Blind. Your spouse was:
65 or older;
Blind.
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.00
41 Enter the larger of line 39 or line 40 ...............................................................................................
41
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.00
42 2015 federal tax liability ($0–$6,450; see instructions for the correct amount) ...........................
42
•
.00
43 Total modifications from Schedule OR-ASC-N/P, section 4...........................................................
43
•
.00
44 Add lines 41, 42, and 43 ................................................................................................................
44
•
.00
45 Taxable income. Line 36 minus line 44. If line 44 is more than line 36, enter -0- ...........................
45
Page 2
150-101-055 (Rev. 12-15)
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