Form 511 - Oklahoma Resident Income Tax Return - 2015 Page 5
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52015 Form 511 - Resident Income Tax Return - Page 5
NOTE: Enclose this page ONLY if you have an amount shown on a schedule or are filing an amended return.
Name(s) shown
Your Social
on Form 511:
Security Number:
Donations from Refund
Schedule 511-G
(Original return only)
This schedule allows you to make a donation from your refund to a variety of Oklahoma organizations. Information regarding each
program, its mission, how funds are utilized, and mailing addresses are shown in Schedule 511-G Information. If you are not receiving
a refund, but would like to make a donation to one of these organizations, Schedule 511-G Information lists the mailing address to mail
your donation to the organization. If you are not receiving a refund and wish to donate to the Public School Classroom Support Fund,
please see line 40 of Form 511.
Place an ‘X’ in the box associated with the dollar amount you wish to have deducted from your refund and donated to that organization.
Then carry that figure over into the column at the right. When you carry your figure back to line 36 of Form 511, please list the line
number of the organization to which you donated. If you donate to more than one organization, please write a “99” in the box at line 36
of Form 511.
Support of Programs for Volunteers to Act
1
as Court Appointed Special Advocates
00
for Abused or Neglected Children.....................
$2
$5
$
...
1
Support of the Oklahoma National Guard ........
$2
$5
$
...
00
2
2
Support of Programs for Regional Food Banks
3
in Oklahoma .....................................................
$2
$5
$
...
00
3
Support of Domestic Violence and Sexual
4
Assault Services ...............................................
$2
$5
$
...
00
4
00
Support of Volunteer Fire Departments ............
$2
$5
$
...
5
5
00
Oklahoma Lupus Revolving Fund ....................
$2
$5
$
...
6
6
Oklahoma Sports Eye Safety Program.............
$2
$5
$
...
00
7
7
Historic Greenwood District Music Festival Fund ..
$2
$5
$
...
00
8
8
00
Public School Classroom Support Fund ...........
$2
$5
$
...
9
9
00
Total donations (add lines 1-9, enter total here and on line 36 of Form 511) ............
10
10
Schedule 511-H: Amended Return Information
Did you file an amended Federal return?
Yes
No
If Yes, enclose a copy of the IRS Form 1040X or 1045 AND a copy of the “Statement of Adjustment”, IRS check or deposit slip. IRS
documents submitted after filing this Oklahoma amended return may delay processing.
Explain the changes to income, deductions, and/or credits below. Enter the line reference number for which you are reporting a change
and give the reason. If more space is needed, enclose a separate schedule.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Information for Schedule 511-G
1- Support for Programs for Volunteers to Act as Court Appoint-
2- Support of the Oklahoma National Guard
ed Special Advocates for Abused or Neglected Children
You have the opportunity to donate from your tax refund for the ben-
You may donate from your tax refund to support programs for volun-
efit of providing financial relief to qualified members of the Oklahoma
teers to act as Court Appointed Special Advocates for abused or ne-
National Guard and their families. Donations will be placed in the In-
glected children. Donations will be placed in the Income Tax Checkoff
come Tax Checkoff Revolving Fund for the Support of the Oklahoma
Revolving Fund for Court Appointed Special Advocates. Monies will
National Guard Relief Program. Monies, to assist Oklahoma National
be expended by the Office of the Attorney General for the purpose of
Guard members and their families with approved hardship expenses,
providing grants to the Oklahoma CASA Association. If you are not
will be expended by the Military Department. If you are not receiv-
receiving a refund, you may still donate. Mail your contribution to:
ing a refund, you may still donate. Please mail your contribution to:
Oklahoma CASA Association, Inc., P.O. Box 54946, Oklahoma City,
Operation Homefront Task Force, 3501 Military Circle, Oklahoma City,
OK 73154.
OK 73111-4398.
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