Form 511x - Amended Resident Individual Income Tax Return - 2004

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511x
State of Oklahoma
Amended Resident Individual Income Tax Return
Revised 2004
_____
Tax Year
Part-year and nonresidents must use Form 511NR.
For the year January 1 - December 31, or other taxable year beginning _________________, ______ ending _________________, ______.
Your Social Security Number
Your first name and initial
Last name
Spouse’s first name and initial
Last name
Spouse’s Social Security Number
Present home address (number and street, including apartment number or rural route)
Did you file an amended Federal return?
City, State and Zip
Yes
No
If “yes” enclose a copy of IRS Form 1040X or 1045 and a copy of
Phone Number
the “Statement of Adjustment”, IRS check, or deposit slip.
(
)
IRS documents submitted after filing Form 511X may delay the
processing of your return.
Filing status claimed:
(Note: Generally, your filing status must be the same as on your Federal return. See Form 511 instructions.)
On original return:
Single
Married filing joint
Married filing separate
Head of Household
Qualifying widow(er)
On this return:
Single
Married filing joint
Married filing separate
Head of Household
Qualifying widow(er)
Number of Exemptions:
Regular
Special
Blind
Dependents
Total
Not Required to File...
On original return:
+
+
+
=
Check this box if you do not
On this return:
+
+
+
=
have sufficient gross income
to require you to file a Federal Return.
Check if you or your spouse are 65 or over:
Yourself
Spouse
A
As Originally
B
C
Income and Deductions...
Amended
Office Use Only
Reported or as
Previously Adjusted
Federal adjusted gross income . . . . . . . . . . . . . . . . . . . .
00
00
1
00
2
Oklahoma subtractions (see instructions) . . . . . . . . . . . .
00
00
00
3
Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
4
Out-of-state income (see instructions) . . . . . . . . . . . . . .
00
00
00
5
Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
6
Oklahoma additions (see instructions) . . . . . . . . . . . . . .
00
00
00
7
Oklahoma adjusted gross income (add lines 5 and 6) . .
00
00
00
8
Adjustments to Oklahoma adjusted gross income
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
9
Subtract line 8 from line 7 . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
10
Deductions and exemptions . . . . . . . . . . . . . . . . . . . . . .
00
00
00
Percentage allowable (divide line 7 by line 3)
11
(not to exceed 100 percent) . . . . . . . . . . . . . . . . . . . . . .
%
%
%
12
Multiply line 10 by line 11 . . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
Oklahoma taxable income - (method 1)
13
subtract line 12 from 9 . . . . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
14
Tax Method 1 (see instructions) . . . . . . . . . . . . . . . . . . . .
00
00
00
15
Federal income tax liability (see instructions) . . . . . . . . . .
00
00
00
Percentage allowable (divide line 7 by line 1)
16
(not to exceed 100 percent) . . . . . . . . . . . . . . . . . . . . . . .
%
%
%
17
Multiply line 15 by line 16 . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
Oklahoma taxable income - (method 2)
18
subtract line 17 from 13 . . . . . . . . . . . . . . . . . . . . . . . . . .
00
00
00
Tax Method 2 (see instructions) . . . . . . . . . . . . . . . . . . . .
19
00
00
00

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