Form 1040x-Me - Maine Individual Income Tax Return
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41040X-ME AMENDED
99
Maine Individual Income Tax Return
*1101800*
For tax period
to
Was your original
Your fi rst name
Initial
Your social security number
Maine return a:
Your last name
Spouse’s social security number
Short Form
Long Form
Spouse’s fi rst name
Initial
Home phone number
Check if:
Spouse’s last name
Work phone number
You were 65 or
over
Home address (number, street and apt. no.)
Blind
Spouse was 65
City/town
State
Zip code
or over
Blind
Check if this is an amended composite return
Check if you were engaged in commercial farming or fi shing
(Partnerships, LLCs and S corporations only)
during the tax period shown above.
Filing status claimed. Note: You cannot change from joint to separate returns after the due date has passed.
On original return ...
Single
Married fi ling joint
Married fi ling separate
Head of household
Qualifying widow(er)
On this return .........
Single
Married fi ling joint
Married fi ling separate
Head of household
Qualifying widow(er)
Residency status claimed.
On original return ................
Resident
“Safe Harbor” Resident
Nonresident
Part-year resident
Nonresident Alien
On this return ......................
Resident
“Safe Harbor” Resident
Nonresident
Part-year resident
Nonresident Alien
Exemptions.
Number on original return
On this return
a.
Yourself
b.
Spouse
Number of boxes checked on a and b ..
c. Number of your dependents
d. Total number of exemptions
.......................
Income and Deductions
A. As Last Filed
B. Net Change
(Note: Be sure to complete the reverse side)
or Adjusted
(Explain on page 2)
C. Correct Amount
1. Federal Adjusted Gross Income .............. 1.
.00
2. Income Modifi cations (See instructions) 2.
.00
3. Maine Adjusted Gross Income (Line 1 plus
.00
or minus line 2) ........................................ 3.
.00
4. Deduction
Standard
Itemized .... 4.
.00
5. Personal Exemption Amount ................... 5.
6. Taxable Income (Line 3 minus lines 4
.00
and 5) ...................................................... 6.
.00
7. Tax (From tax tables)............................... 7.
.00
8. Tax Additions (Attach Maine Schedule A) 8.
.00
9. Low-Income Credit ................................. 9.
.00
10. Use Tax ................................................. 10.
10a. Sales Tax on Casual Rentals of Living Quarters 10a.
.00
CONTRIBUTION and
PARK PASS AMOUNTS
.00
11. Voluntary Contributions and Park Passes.. 11.
CANNOT BE CHANGED
12. Tax Credits (Attach Maine Schedule A) ... 12.
.00
13. Nonresident Credit (Attach Maine
Schedule NR or NRH) ............................. 13.
.00
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