Form Ri-1040x-Nr - Amended Rhode Island Nonresident Individual Income Tax Return - 2012
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5Amended Rhode Island Nonresident Individual Income Tax Return
RI-1040X-NR
2012
(To be used by nonresident and part-year resident taxpayers only)
First name
Initial
Last name
Your social security number
NAME AND
ADDRESS
Initial
Last name
Spouse’s social security number
Spouse’s first name
Present home address (number and street, including apartment no. or rural route)
Daytime telephone number
Please
(
)
print or type
City or town of legal residence
City, town or post office
State
ZIP code
A.
Enter name and address used on original return (if same as above write “SAME”)
ADDITIONAL
INFORMATION
B.
Are you filing an amended federal income tax return? ...................................................................................
Yes
C.
Have you been advised your federal return is under examination? ...............................................................
Yes
D.
On original return
FILING
1. Single
2. Married filing jointly
3. Married filing separately
4. Head of Household
5. Qualifying widow(er)
STATUS
E.
On this return
1. Single
3. Married filing separately
4. Head of Household
5. Qualifying widow(er)
2. Married filing jointly
INCOME AND TAX
A. Originally reported
B. Net change
C. Correct amount
1.
Federal AGI (Adjusted Gross Income)........................................................
1.
Single
$7,800
2.
Modifications from RI-1040NR, Schedule M, line 3..................................
2.
Married
3.
3.
Modified Federal AGI. Combine lines 1 and 2...........................................
filing jointly
or
4.
Deductions
(see
instructions).....................................................................
4.
Qualifying
widow(er)
5.
Subtract line 4 from line 3...........................................................................
5.
$15,600
6.
Exemptions. Enter the number of federal exemptions
Married
claimed on this return in the box then multiply by
6.
filing
$3,650 and enter the result on line 6, column C.
separately
7.
RI Taxable Income. Subtract line 6 from line 5..........................................
7.
$7,800
Head of
8.
RI income tax from RI Tax Table or Tax Computation Worksheet..............
8.
household
9.
$11,700
RI percentage of allowable federal credit from RI-1040NR, page 2, line 25......
9.
10.
RI tax after allowable federal credit - before allocation...................................
10.
11.
RI allocated income tax (check only one)
All income is from RI, enter the amount from line 10 on this line.
11.
Nonresident with income from outside RI, complete RI-1040NR, Sch II.
Part-year resident with income from outside RI, complete RI-1040NR, Sch III.
12.
Other RI credits from RI-1040NR, Schedule CR, line 4.............................
12.
13A.
13A.
RI income tax after credits. Subtract line 12 from line 11
(not less than
0)..
13B.
Recapture of Prior Year Other Rhode Island Credits, Schedule CR, line 7
13B.
14.
14.
RI checkoff contributions from RI-1040NR, page 2, line 33.......................
15.
15.
USE/SALES tax due from Consumer’s Use Tax Worksheet, page 4, line 5
16.
16.
Total RI Tax and checkoff contributions. Add lines 13A, 13B, 14 and 15..
PAYMENTS
17.
A.
RI 2012 income tax withheld from Schedule W, line 21......................
17A.
Attach
B.
2012 estimated tax payments and 2011 carryforward........................
17B.
only the
C.
Nonresident withholding on real estate sales in 2012........................
17C.
supporting
forms and
17D.
D.
RI Earned Income Credit....................................................................
schedules
E.
Other Payments ........................................................................................................................................................
17E.
for the
items
F.
Total. Add lines 17A, 17B, 17C, 17D and 17E..........................................................................................................
17F.
changed.
G.
Overpayment allowed on original return....................................................................................................................
17G.
H.
Total payments after overpayment. Subtract line 17G from 17F...............................................................................
17H.
AMOUNT
18. A. If line 16 is larger than 17H, subtract line 17H from 16. This is the amount you owe...................................
18A.
DUE
B.
Interest due on amount on line 18A ...............................................................................................................
18B.
C.
Total balance due. Add lines 18A and 18B ...................................................................................................
18C.
REFUND
19. If line 17H is larger than line 16, subtract line 16 from 17H. This is the amount you overpaid.............................
☺
19.
20.
Amount of overpayment to be refunded..................................................................................................................
20.
21.
Amount of overpayment to be applied to 2013 estimated tax ..............................................
21.
RETURN MUST BE SIGNED - SIGNATURE LINE IS LOCATED ON PAGE 2
Mail returns to: RI Division of Taxation - One Capitol Hill - Providence, RI 02908-5806
page 1
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