Form Ri-1040 - Resident Individual Income Tax Return - 2014 Page 2

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State of Rhode Island and Providence Plantations
2014 Form RI-1040
14100199990102
Resident Individual Income Tax Return
Name
Your social security number
RI SCHEDULE I - ALLOWABLE FEDERAL CREDIT
19
RI income tax from page 1, line 8 ................................................................................................................................
19
20
Credit for child and dependent care expenses from Federal Form 1040, line 49
or Form 1040A, line 31............................................................................................
20
21
Tentative allowable federal credit. Multiply line 20 by 25% (0.2500)..........................................................................
21
22
MAXIMUM CREDIT. Line 19 or 21, whichever is SMALLER. Enter here and on page 1, line 9a .............................
22
RI SCHEDULE II - CREDIT FOR INCOME TAX PAID TO ANOTHER STATE
NOTE: You must attach a signed copy of the state tax return(s) for which you are claiming credit.
23
RI income tax from RI-1040, page 1, line 8 less allowable federal credit from RI-1040, page 2, line 22 ....................
23
24
Income derived from other state. If more than one state, see instructions................................................................. 24
Modified federal AGI from page 1, line 3 ..................................................................................................................... 25
25
_ . _ _ _ _
26
Divide line 24 by line 25........................................................................................................................................................ 26
27
Tentative credit. Multiply line 23 by line 26........................................................................................................................... 27
Tax due and paid to other state (see specific instructions). Insert name of state paid
28
28
29
MAXIMUM TAX CREDIT. Line 23, 27 or 28, whichever is the SMALLEST. Enter here and on page 1, line 9b ........ 29
RI CHECKOFF CONTRIBUTIONS SCHEDULE
$1.00
$5.00
$10.00 Other
30
Drug program account RIGL §44-30-2.4 .........................
30
31
Olympic Contribution RIGL §44-30-2.1 ....... Yes
$1.00 contribution ($2.00 if filing a joint return) ....
31
32
RI Organ Transplant Fund RIGL §44-30-2.5 ...................
32
33
RI Council on the Arts RIGL §42-75.1-1 ..........................
33
34
RI Nongame Wildlife Fund RIGL §44-30-2.2 ...................
34
35
Childhood Disease Victim’s Fund RIGL §44-30-2.3 ........
35
36
RI Military Family Relief Fund RIGL §44-30-2.9 ................
36
37
37
TOTAL CONTRIBUTIONS. Add lines 30, 31, 32, 33, 34, 35 and 36. Enter here and on RI-1040, page 1, line 11..........
RI SCHEDULE EIC - RHODE ISLAND EARNED INCOME CREDIT
38
Rhode Island income tax from RI-1040, page 1, line 10a............................................................................................
38
39
Federal earned income credit from Federal Form 1040, line 66a; 1040A, line 42a, or 1040EZ, line 8a .....................
39
40
Rhode Island percentage.............................................................................................................................................
25%
40
41
Multiply line 39 by line 40 ......................................................................................................................................................
Enter the SMALLER of line 38 or line 41 ..............................................................................................................................
42
42
43
Subtract line 42 from line 41. If zero or less, enter the amount from line 42 on line 46. Otherwise, go to line 44 ......
43
44
Refundable percentage...............................................................................................................................................
15%
44
45
Rhode Island refundable earned income credit. Multiply line 43 by line 44................................................................
45
46
TOTAL RI EARNED INCOME CREDIT. Add line 42 and line 45. Enter here and on RI-1040, line 14d ....................
46
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, it is true, accurate and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature
Spouse’s signature
Date
Telephone number
Paid preparer signature
Print name
Date
Telephone number
Paid preparer address
City, town or post office
State
ZIP code
PTIN
May the Division of Taxation contact your preparer? YES
Revised 10/2014
Page 2

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