Form 482.0 R - Individual Income Tax Return - 2001

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Form 482.0 Rev. 05.01
G
LONG FORM
LONG FORM
RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)
RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)
LONG FORM
LONG FORM
LONG FORM
RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)
RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)
RETURN WITH CHECK (PLEASE ATTACH CHECK HERE)
Serial Number
COMMONWEALTH OF PUERTO RICO
2001
2001
2001
2001
2001
2001
2001
2001
2001
2001
Liquidator
Reviewer
DEPARTMENT OF THE TREASURY
INDIVIDUAL INCOME TAX RETURN
INDIVIDUAL INCOME TAX RETURN
INDIVIDUAL INCOME TAX RETURN
INDIVIDUAL INCOME TAX RETURN
INDIVIDUAL INCOME TAX RETURN
G
G
R M RO V1 V2 P1 P2 N D E A G
G
FOR CALENDAR YEAR 2001 OR TAXABLE YEAR BEGINNING ON
________________ , ____ AND ENDING ON ________________, ____
Payment Stamp
First Name
Initial
Last Name
Second Last Name
Social Security Number
Social Security Number
Social Security Number
Social Security Number
Social Security Number
Sex
Sex
Sex
Sex
Sex
Date of Birth
Postal Address
G
G
M M M M M
F F F F F

Day
Month
Year
Spouse's Social Security Number
Spouse's Social Security Number
Spouse's Social Security Number
Spouse's Social Security Number
Spouse's Social Security Number
Zip Code
Spouse's Date of Birth
"Place Label here".
"Place Label here".
"Place Label here".
"Place Label here".
"Place Label here".
Day
Month
Year
Spouse's First Name and Initial
Last Name
Second Last Name
Home Telephone
(
)
-
Office Telephone
Home Address (Town or Urbanization, Number, Street)
(
)
-
CHANGE OF ADDRESS
CHANGE OF ADDRESS
CHANGE OF ADDRESS
CHANGE OF ADDRESS
CHANGE OF ADDRESS
Receipt Number:
G
G


Zip Code
Amount:
Yes

No
FILING STATUS AT THE END OF THE TAXABLE YEAR:
FILING STATUS AT THE END OF THE TAXABLE YEAR:
FILING STATUS AT THE END OF THE TAXABLE YEAR:
FILING STATUS AT THE END OF THE TAXABLE YEAR:
FILING STATUS AT THE END OF THE TAXABLE YEAR:
YES
YES
YES
YES
YES
NO
NO
NO
NO
NO
G
GG
A.
1)
Married living with spouse and filing jointly
United States Citizen?
G
GG
B.
2)
Married not living with spouse (Not head of household)
Resident of Puerto Rico at the end of the year?
GG
C.
(Indicate spouse's name and social security number)
Tax exempt income from Lottery of Puerto Rico?
GG
G
D.
3)
Head of household
Income from racetrack winnings in Puerto Rico?
GG
G
E.
4)
Single
Other exempt income? (Submit Schedule)
(Submit Schedule)
(Submit Schedule)
(Submit Schedule)
(Submit Schedule)
GG
G
F.
5)
Married filing separately (Indicate spouse's name and social security number)
Obligation to make payments to ASUME
ASUME
ASUME
ASUME?
ASUME
G G G G G OVERNMENT CONTRACT
OVERNMENT CONTRACT
OVERNMENT CONTRACT
OVERNMENT CONTRACT
OVERNMENT CONTRACT
HIGHEST SOURCE OF INCOME:
HIGHEST SOURCE OF INCOME:
HIGHEST SOURCE OF INCOME:
HIGHEST SOURCE OF INCOME:
HIGHEST SOURCE OF INCOME:
G
G
J.
G.
G
G


G
G
K.
TAXPAYER
SPOUSE
H.
G
I.
RETURN
RETURN
RETURN
RETURN
RETURN
G
G

Your occupation
Spouse's occupation
SPANISH
ENGLISH
Receipt Stamp
Receipt Stamp
Receipt Stamp
Receipt Stamp
Receipt Stamp
Wages, Commissions, Allowances and Tips
Wages, Commissions, Allowances and Tips
Wages, Commissions, Allowances and Tips
Wages, Commissions, Allowances and Tips
Wages, Commissions, Allowances and Tips
A-Income Tax Withheld
B-Wages, Commissions,
Allowances and Tips








G
Total
Total
Total
Total
Total (Number of withholding
statements with this return)


Federal Wages
Income Tax Withheld
C-
Federal Government Wages
Federal Government Wages
Federal Government Wages
Federal Government Wages
Federal Government Wages (See instructions)...........................................................


(01)
(02)
Other Income (or Losses):
Other Income (or Losses):
Other Income (or Losses):
Other Income (or Losses):
Other Income (or Losses):

(03)
A)
Interest income (Schedule F Individual, Part I, line 9) ......................................................................................................

(04)
B)
Distributable share on special partnerships profits (Submit Schedule F Individual and Schedule R) ...........................

(05)
C)
Distributable share on special partnerships losses (Submit Schedule R) .....................................................................

(06)
D)
Dividends from corporations and distributions from partnerships subject to withholding (Schedule F Individual, Part II, line 1A)..

(07)
E)
Dividends from corporations and distributions from partnerships not subject to withholding (Schedule F Individual, Part II, line 1B)..

(08)
F)
Distributable share on profits from Subchapter N corporations of individuals (Submit Schedule F Individual) ....................

G)
(09)
Miscellaneous income (Submit Schedule F Individual)...................................................................................................

H)
(10)
Dividends from Capital Investment or Tourism Fund (Submit Schedule Q1) ...................................................................

I)
(11)
Income from annuities and pensions (Schedule H Individual, Part II, line 12) ....................................................................

J)
(13)
Alimony received (Payer's social security No. _________________________ )
............................................................
(12)

K)
(14)
Gain (or loss) from industry or business (Submit Schedule K Individual) ....................................................................

L)
(15)
Gain (or loss) from farming (Submit Schedule L Individual) .........................................................................................

M)
(16)
Gain (or loss) from professions and commissions (Submit Schedule M Individual)......................................................

N)
(17)
Gain (or loss) from rental business (Submit Schedule N Individual).............................................................................

O)
(18)
Gain (or loss) from sale or exchange of capital assets and Qualified pension plans (Submit Schedule D Individual)...........

P)
(19)
Net long-term capital gain on Investment Funds (Submit Schedule Q1) .........................................................................

(20)
Total Gross Income
Total Gross Income
Total Gross Income
Total Gross Income
Total Gross Income (Add lines 1B, 1C and 2A through 2P)............................................................................................

(22)
Alimony Paid
Alimony Paid
Alimony Paid
Alimony Paid
Alimony Paid (Recipient's social security No. _________________________ )
...................................................................
(21)

(30)
Adjusted Gross Income
Adjusted Gross Income
Adjusted Gross Income
Adjusted Gross Income
Adjusted Gross Income (Subtract line 4 from line
3)....................................................................................................................

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