Form D-40 - Individual Income Tax Return - 2011 Page 2
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D-40 PAGE 2
*110400120002*
Enter your last name.
Enter your SSN.
16
Deduction type.
Take the same type as you took on your federal return. Fill in which type:
Standard or
Itemized
See page 20 for amount to enter on Line 17.
.
$
00
17
17
DC deduction amount.
Do not copy from federal return. For amount to enter, see page 21.
17a
RESERVED
.00
$
18
18
Number of exemptions.
If more than 1 (more than 2 if filing jointly), or if you or your
spouse/domestic partner are over 65 or blind, attach a completed Calculation G, Schedule S.
.
$
00
19
Exemption amount.
19
Multiply $1,675 by number on line 18. Part-year DC residents see Calculation E, page 19.
.
20
Add Lines 17 and 19.
$
00
20
21
DC taxable income.
.
Subtract Line 20 from Line 15. Enter result.
$
00
21
Fill in if loss
DC tax, credits and payments
.
$
00
22
Tax.
22
If Line 21 is $100,000 or less, use tax tables on pages 47-56. If more, use Calculation I, page 21.
Fill in
if filing separately on same return.
Complete Calculation J on Schedule S.
.
$
00
$
23
23
Credit for child and dependent care expenses
.00 X .32
Enter result >
From Line 9 of fed. Form 2441; from Line 5, DC Form D-2441, if part-year DC resident.
.
$
00
24
Non-refundable credits from DC Schedule U, Part 1a, Line 6.
24
Attach Schedule U.
.
$
00
25
DC Low Income Credit.
25
See table on page 11. Take either this credit or Line 28 credit – not both.
25a
Enter the number of exemptions claimed on your federal return.
25a
.
$
00
26
26
Total non-refundable credits.
Add Lines 23, 24 and 25.
.
$
00
27
Total tax.
27
Subtract Line 26 from Line 22. If Line 22 is less than Line 26 leave Line 27 blank.
.
$
00
28
.00 X .40
DC Earned Income Tax Credit. Enter your federal EIC.
28
$
Enter result >
28a Enter the number of qualified EITC children.
28a
.
$
00
29
Property Tax Credit.
.
29
From your DC Schedule H; attach a copy
.
$
00
30
Refundable credits from DC Schedule U, Part 1b, Line 4.
30
Attach Schedule U.
.
$
00
31
DC income tax withheld
31
shown on Forms W-2 and 1099. Attach these forms.
.
$
00
32
2011 estimated income tax payments.
32
.
$
00
33
Tax paid with extension of time to file or with original return if this is an amended return.
33
.
$
00
34
Total payments and refundable credits
34
Add Lines 28, 29–33.
Amount owed
–
Refund
Complete if Line 34 is equal to or less than Line 27
–
Complete if Line 34 is more than Line 27
.
$
00
41 Tax due
41
$
00
35 Amount you overpaid
35
Subtract Line 34 from Line 27
Subtract Line 27 from Line 34
.
$
00
$
00
42
42 Contribution amount
36
36 Amount to be applied
from Sched. U, Part II, Line 7
to your 2012 estimated tax
$
00
37 Penalty
.
See instructions
37
00
43a Penalty
$
38 Refund
$
00
.
Subtract sum of
38
00
43b Interest
$
Lines 36 and 37 from Line 35
.
$
00
$
00
Enter total P & I
39 Contribution amount
43
39
from Sched. U, Part II, Line 6
.
$
00
44 Total amount due
44
Can not exceed refund amt. on Line 38
Put additional amt. on Line 42
Add Lines 41–43
$
00
40 Net refund
40
Subtract Line 39 from Line 38
Will the refund you requested go to an account outside the U.S.?
Yes
No
See page 8.
Direct Deposit.
To have your refund deposited to your checking
or savings
account, fill in oval and enter bank routing and account numbers. See page 7.
Routing Number
Account Number
Third party designee
To authorize another person to discuss this return with OTR, fill in here
and enter the name and phone number of that person. See instructions, page 8.
Designee’s name
Phone number
Signature
Under penalties of law, I declare that I have examined this return and, to the best of my knowledge, it is correct. Declaration of paid preparer is based on information available to the preparer.
Paid preparer’s signature
Date
Your signature
Date
Paid preparer’s PTIN
Paid preparer’s phone number
Spouse’s/domestic partner’s signature if filing jointly or separately on same return
Date
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2011 D-40 P2
Individual Income Tax Return page 2
File order 2
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