Form 511nr - Oklahoma Nonresident/part-Year Income Tax Return - 2012

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Oklahoma Nonresident/
Form 511NR - 2012
Part-Year Income Tax Return
This form has been enhanced to complete all calculations, and to print a two
dimensional (2D) barcode. The data entered on the form will be contained in the
AMENDED
Your Social Security Number
Place an ‘X’ in this box
RETURN!
barcode. The Oklahoma Tax Commission can read the barcode, process it
if this taxpayer
immediately into our system, and eliminate the need for manual data entry.
If filing an Amended Return,
is deceased
enclose a copy of your
Ultimately, this will mean faster refunds for the taxpayer of Oklahoma.
Federal Amended Return
Spouse’s Social Security Number
and IRS acceptance.
Place an ‘X’ in this box
Place an ‘X’ in this box
Please check over the form carefully and make any changes needed prior to
(joint return only)
if this is an
if this taxpayer
printing the form. Changes made after printing the form will not be reflected in the
amended
is deceased
barcode and may result in a delay in the processing of your return.
511NR:
Please mail your tax return to the following address.
Your first name, middle initial and last name
Oklahoma Tax Commission - PO Box 269045
Oklahoma City OK 73126-9045
If a joint return, spouse’s first name, middle initial and last name
If you need assistance, please contact us at 405-521-3160
Mailing address (number and street, including apartment number, rural route or PO Box)
Not Required to File
Place an ‘X’ in this box if you do not have an Oklahoma filing
Check this box if you do not have an Oklahoma filling requirement and are
City, State and Zip
requirement and are filing for refund of State withholding.
filing for refund of your Oklahoma withholding.(see instructions)
(see instructions)
* NOTE: If claiming Special Exemption, see instructions on page 8 of 511NR Packet.
1
Single
2
Married filing joint return
Regular
Special
Blind
(even if only one had income)
*
Married filing separate
Add the Totals from
3
Yourself
the 4 boxes.
=
+
+
• If spouse is also filing,
Write the Total
in the box below.
list SSN and name in box:
Total
+
+
Spouse
=
4
Head of household with qualifying person
=
5
Qualifying widow(er) with dependent child
Number of dependent children
=
• Please list the year spouse died in box at right:
Note: If you may
be claimed as a
dependent on another
return, enter “0”
=
Number of other dependents
Nonresident(s) State of Residence: ________________
for your regular
exemption.
Part-Year Resident(s) From ___________ to _________
Spouse
Resident/Part-Year Resident/Nonresident
Yourself
Age 65 or Over?
(Please see instructions)
State of Residence: Yourself _________ Spouse _______
Please Round to Nearest Whole Dollar
Begin Here
to arrive at Oklahoma Adjusted Gross Income. Lines 1-19: In the Federal column, enter the amounts from your Federal Tax Return.
See the instructions to figure the amounts to report in the Oklahoma column.
Federal Amount
Oklahoma Amount
1
Wages, salaries, tips, etc ..............................................................
00
00
1
2
00
00
Taxable interest income ................................................................
2
3
Dividend income ...........................................................................
00
00
3
4
00
00
Taxable refunds (state income tax)...............................................
4
5
00
00
Alimony received ..........................................................................
5
6
Business income or (loss) (Federal Schedule C) .........................
00
00
6
7
00
00
Capital gains or losses (Federal Schedule D) ..............................
7
8
Other gains or losses (Federal Form 4797)..................................
00
00
8
9
00
00
Taxable IRA distribution ................................................................
9
10
00
00
Taxable pensions and annuities ...................................................
10
11
Rental real estate, royalties, partnerships, etc .............................
00
00
11
12
00
00
Farm income or (loss) ...................................................................
12
13
Unemployment compensation ......................................................
00
00
13
Taxable Social Security benefits
14
00
00
.......
14
(also enter on line 2 of Sch. 511NR-B)
15
00
00
Other income (identify: ________________________________)
15
16
Add lines 1 through 15..................................................................
00
00
16
17
00
00
Total Federal adjustments to income (identify: ______________)
17
Oklahoma source income (line 16 minus line 17)......................
18
00
18
Federal adjusted gross income (line 16 minus line 17) ............
19
00
19
20
00
00
Oklahoma additions: Schedule 511NR-A, line 8 ..........................
NR-A
20
21
Add lines (Federal 19 and 20) and then (Oklahoma 18 and 20) ..
00
00
21
22
NR-B
00
00
Oklahoma subtractions: Schedule 511NR-B, line 15 ....................
22
Adjusted gross income: Okla. Source (line 21 minus line 22) .........
23
00
23
Adjusted gross income: All Sources
24
00
24
(line 21 minus line 22) Also enter on line 25

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