Telefile Worksheet - Iowa Department Of Revenue And Finance - 2002

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IOWA
IOWA
2002
TeleFile
Worksheet
department of Revenue and Finance
DEPARTMENT
OF
and
Your Social Security Number
4-digit PIN #
Spouse Social Security Number
RETAIN FOR YOUR RECORDS
Do Not Mail
yes
no
1
Enter your filing status number, Single = 1, Married filing joint = 2
If filing status “1”, were you claimed as a dependent on another person’s Iowa income tax return
2
Enter the total number of W-2 forms (5 or less)
Enter your 2002 W-2 information in the appropriate boxes below
3
Wages
Federal
Iowa
Employer ID Number
(without hyphen)
(Including Tips)
Tax Withheld
Tax Withheld
$
$
$
1st W-2
NOTE:
,
,
,
$
Round all
$
$
2nd W-2
,
,
,
amounts
$
$
$
3rd W-2
to the
,
,
,
nearest dollar.
$
$
$
4th W-2
,
,
,
(ex: $57.50 = $58;
$
$
$
5th W-2
$57.49 = $57)
,
,
,
$
Total taxable interest income from 1099’s
4
$
Total ordinary dividend income from 1099’s
5
Income
Federal Tax Withheld Iowa Tax Withheld
6
Unemployment compensation
$
,
$
,
$
,
Federal income tax refund received in 2002
$
,
7
8
Additional Federal tax paid in 2002 for 2001 and any prior years
$
,
2002 Federal earned income credit
$
,
9
$
,
To contribute to the Fish and Wildlife Fund, enter an amount..................
10
$
,
To contribute to the State Fairgrounds Renovation, enter an amount.....
$
,
To contribute to the Keep Iowa Beautiful Fund, enter an amount............
To direct deposit your refund, the following information is needed:
Routing Transit Number (RTN) of your financial institution
11
Before you call,
Type of Account Depositing to: Checking
Savings
please be sure you have
Depositor Account Number
completed this worksheet,
$1.50 to Republican Party
$1.50 to Republican Party
Iowa Election
and made entries in
$1.50 to Democratic Party
$1.50 to Democratic Party
12
YOURSELF
SPOUSE
Campaign Fund
$1.50 to Green Party
$1.50 to Green Party
the appropriate boxes.
$1.50 to Campaign Fund
$1.50 to Campaign Fund
You are ready to TeleFile
STOP
STOP
Dial 1-888-829-3742
TeleFile
will calculate your return using the standard deduction amount and tell you the following amounts.
Enter the amounts in the boxes provided below.
$
,
Amount you owe...................
$
,
Iowa net income ...........................................
Amount of refund after
$
,
contributions from line 10 ...
$
,
Amount of your refund .................................
Amount of tax you owe after
$
,
contributions from line 10 ...
Confirmation #
Date Filed
Are you paying additional tax?
Pay online or mail payment to Iowa Income Tax - Document Processing, PO Box 9187, Des Moines IA 50306-9187
8/21/02 41-144

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