Form 40s - Oregon Individual Income Tax Return - 2000
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1
2Oregon
Form
2000
S
Individual
40
For office use only
Income Tax
Date received
FULL-YEAR
Return
RESIDENTS ONLY
SHORT FORM
Last name
First name and initial
Enter your Social Security No. (SSN)
Birth year
For office
use only
1
Spouse’s last name if different and joint return
Spouse’s first name and initial if joint return
Enter spouse’s SSN, if joint return
Spouse’s
birth year
2
Current mailing address
Telephone number
(
)
3
City
State
ZIP code
If you filed a return in 1999, and this
address is different, check here
•
1
Single
Exemptions
Severely
•
Filing
Total
Regular
disabled
2
Status
Married filing jointly
6a Yourself
6a
3
Married filing separately
6b Spouse
b
Check
(Spouse’s name)
only one
6c All dependents
•
c
(Spouse’s Social Security number)
box
(First names)
4
•
d
Head of household
6d Disabled
(Person who qualifies you)
(First names)
•
6e
children only
Total
5
Qualifying widow(er) with dependent child
•
•
7 Check if: You were:
65 or older
Blind
If someone else can claim you
Check if you filed
Check here to donate your kicker
•
Spouse was:
as a dependent, check here
an extension
refund to the School Fund
65 or older
Blind
•
8 Wages, salaries, tips, commissions, and other pay for work
8
•
9 Interest: 9a
plus Dividends: 9b
9
•
10 Unemployment compensation. See instructions, page 9
10
11
11 Total income. Add lines 8 through 10
•
12 2000 federal tax liability. ($0 - $3,000, see instructions for the correct amount)
12
13 Standard deduction from the back of this form
13
14 Add lines 12 and 13
14
•
•
15 Oregon taxable income. Line 11 minus line 14. If line 14 is more than line 11, fill in -0-
15
•
•
16
16 Tax from tables, pages 21 through 23
17
EXEMPTION CREDIT.
Multiply your total exemptions on line 6e by $139
17
•
18 Earned income credit. See instructions, page 10
18
•
19 Working family credit. See instructions, page 10
19
•
20 Child and dependent care credit. See instructions, page 10
20
•
21 Other credits (see instructions). Identify
21
22 Total credits. Add lines 17 through 21
22
•
•
23
23 Net income tax. Line 16 minus line 22. If line 22 is more than line 16, fill in -0-
•
24 Oregon tax withheld from income. Attach your Form(s) W-2 and 1099
24
•
•
25
REFUND. If line 24 is more than line 23, you have a refund. Line 24 minus line 23
REFUND
25
•
•
26
TAX-TO-PAY.
If line 23 is more than line 24, you have tax to pay. Line 23 minus 24
TAX-TO-PAY
26
I wish to donate part of my tax refund to the following fund(s):
•
27 Oregon Nongame Wildlife
$1,
$5,
$10,
Other $ ______
27
•
28 Child Abuse Prevention
$1,
$5,
$10,
Other $ ______
28
These will
•
29 Alzheimer’s Disease Research
$1,
$5,
$10,
Other $ ______
29
reduce
•
30
Stop Domestic & Sexual Violence
$1,
$5,
$10,
Other $ ______
30
your refund
•
31 AIDS/HIV Education and Services
$1,
$5,
$10,
Other $ ______
31
•
•
32 Other charity. Enter code _______
$1,
$5,
$10,
Other $ ______
32
33 Total donations. Add lines 27 through 32. Total can’t be more than your refund on line 25
33
34
NET REFUND. Line 25 minus line 33. This is your net refund
NET REFUND
34
Under penalties for false swearing, I declare that I have examined this return, including accompanying schedules and statements. To the best of my knowledge and be-
lief is true, correct, and complete. If prepared by a person other than the taxpayer, this declaration is based on all information of which the preparer has any knowledge.
SIGN
Your signature
Date
Signature of preparer other than taxpayer
License No.
HERE
Address
Spouse’s signature (If filing jointly, BOTH must sign even if only one had income)
150-101-044 (Rev. 9-00) Web
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