Schedule B (Form Ia 1040) - Interest And Dividend Income - 2015

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Iowa Department of Revenue
https://tax.iowa.gov
2015 IA 1040 Schedule B
Interest and Dividend Income
Name(s) shown on return
Social Security Number
Note: You must report all taxable interest and dividends on IA 1040 even if you are not required to complete Schedule B.
Total Taxable Interest and Dividends:
 Filing status 1, 2, 5, or 6 – the amount entered in column A on the IA 1040 will be the total taxable interest and
dividends from accounts owned by the taxpayer; nothing is reported in column B.
 Filing status 3 – the amount entered in column A on the IA 1040 will be the total taxable interest and dividends from
accounts owned by the taxpayer, plus 50% of any amount from a joint account. The amount entered in column B on
the IA 1040 will be the total taxable interest and dividends from accounts owned by the spouse, plus 50% of any
amount from a joint account.
 Filing status 4 – the amount entered in column A on the IA 1040 will be the total taxable interest and dividends from
accounts owned by the taxpayer, plus 50% of any amount from a joint account; nothing is reported in column B.
Account Ownership: For each payer, indicate the type of account ownership. If the interest and/or dividends were
earned by you, check “Taxpayer.” For interest and/or dividends earned by your spouse, check “Spouse.” If the interest
and/or dividends were earned jointly, check “Joint.” Check only one for each payer.
Part I: Interest Income
Complete Part I if you received more than $1,500 in interest in 2015. Interest income which should be reported includes
earnings from savings and loan associations, mutual savings banks, cooperative banks, credit unions, and bank deposits;
state and municipal bonds (see instructions for IA 1040, line 2, Taxable Interest Income), and interest from tax refunds.
Report total, exempt, and taxable interest.
Total Interest
Interest
Name of Payers
List names of all payers. If additional lines are needed,
(must equal the total of
Exempt from
Taxable
Exempt & Taxable
include additional page.
Iowa Tax
Interest
Interest)
Taxpayer
Spouse
Joint
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total taxable interest entered on line 2 of the IA 1040 .......$
$
$
Part II: Dividend Income
Complete Part II if you received more than $1,500 in gross dividends in 2015. Report total, exempt, and taxable dividends.
Total Dividends
Dividends
Name of Payers
(must equal the total of
List names of all payers. If additional lines are needed,
Exempt from
Taxable
Exempt & Taxable
include additional page.
Iowa Tax
Dividends
Dividends)
Taxpayer
Spouse
Joint
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total taxable dividends entered on line 3 of the IA 1040 ....$
$
$
Include a copy of this schedule with your return.
41-029 (09/08/2015)

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