Sd Eform-1291 - Application For Paraplegic Property Tax Reduction - 2012 Page 3

Download a blank fillable Sd Eform-1291 - Application For Paraplegic Property Tax Reduction - 2012 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Sd Eform-1291 - Application For Paraplegic Property Tax Reduction - 2012 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

INFORMATION FOR TAX RELIEF PROGRAMS IN SOUTH DAKOTA – 2012 APPLICATION
1. Personal Information
Last Name
First Name
Social Security Number
Mailing Address
County
Telephone
(day)
(month)
(year)
City
State
Zip Code
Birth Date
=============================================================================
2. Income Calculation – Attach a copy of your completed 2012 Federal Income Tax Return
=============================================================================
Did you file a 2012 Income Tax Return? (circle one)
YES
NO
If yes - - attach a copy of the return
Federal Adjusted Gross Income
$ _________________
Excluded interest not $________________
yet listed
Wages, salaries, tips, other
$ _________________
Alimony payments not $________________
employee compensation
yet listed
Interest
$ _________________
Dividends
$ _________________
Support Payments
$ _______________
Self-employment (explain)
$ _________________
Cash Public Asst.
$ _______________
& Relief
Social Security (attach a copy of
$__________________
Capitol Gains exc
$ _______________
Each household member SSA-1099
From adj. gross income
Medicare premiums
$ __________________
Workers Comp
$ ________________
Title 19, 20 or SSI
$ __________________
Loss of time
$ ________________
insurance
Veterans benefits
$ __________________
Interest & dividend
$ ________________
Left to accum. except on insurance policies
Railroad retirement benefits
$ __________________
Other Income
$ ________________
Other Pensions and annuities
$ __________________
TOTAL INCOME
$________________
0.00
(Attach all documents of income)
PRINT FOR MAILING
CLEAR FORM

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 3