Form 40 - Schedules A,b,cr,&dc - Itemized Deductions, Interest And Dividend Income, Credit For Taxes Paid To Other States, Donation Check-Offs - 2012 Page 2

120004401283

Sch. A, B, CR, & DC

(Form 40) 2012

Page 2

Name(s) as shown on Form 40 (Do not enter name and social security number if shown on other side)

Your social security number

SCHEDULE B – Interest And Dividend Income

If you received more than $1500 of interest and dividend income, you must complete Schedule B. See instructions on page 21.

B

A

List Payers and Amounts

Taxable Interest

Exempt Interest

and Dividends

00

00

1

00

00

I

00

00

N

T

00

00

E

00

00

1

1

R

00

00

E

S

00

00

T

00

00

00

00

00

2

00

D

I

00

V

00

I

D

00

2

E

00

N

D

00

S

00

00

3

TOTAL TAXABLE INTEREST AND DIVIDENDS

•

00

3

Enter here and on Form 40, page 1, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SCHEDULE CR – Credit For Taxes Paid To Other States

See instructions on page 21. PLEASE NOTE: You may need to use the example computation on page 21 to calculate your income from the other state before completing this schedule. This

credit will NOT be allowed unless you file a nonresident income tax return with the other state and attach a copy of that 2012 return to your Alabama return.

00

1

1 2012 taxable income as shown on the

state return. . . . . . . . . . . . . . .

If more than one “other” state,

(name of state)

skip lines 1-4 and use Schedule

00

2

2 Tax due the other state using Alabama tax rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CR worksheet. If using the

00

worksheet, line 5 (below) will

3

3 Tax due the other state as shown on that state’s return or Form W-2G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

equal worksheet Part 4, line 21.

00

4

4 Tax due Alabama from Form 40, page 1, line 17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 CREDIT ALLOWABLE. Enter the amount from line 2, 3, 4, or the amount from the worksheet on page 21 of the

booklet, whichever is smallest. If you have no other credits, enter amount from line 5 to Form 40, page 1, line 18.

If you have other credits, enter the amount from line 5 to Schedule OC, Part A, line 1, and complete. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . •

00

5

SCHEDULE DC – Donation Check-Offs

1 You may donate all or part of your overpayment. (Enter the amount in the appropriate boxes.)

•

00

00

a Senior Services Trust Fund. . . . . . . . . . . . . . . . . . . . . . . .

k Alabama Breast & Cervical Cancer Program . . . . . . . . . . . . . . .

•

00

00

b Alabama Arts Development Fund. . . . . . . . . . . . . . . . . . .

l Alabama 4-H Club . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

00

c Alabama Nongame Wildlife Fund. . . . . . . . . . . . . . . . . . .

m Alabama Organ Center Donor Awareness Fund . . . . . . . . . . . .

•

00

00

d Child Abuse Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Alabama National Guard Foundation Incorporated . . . . . . . . . .

•

00

00

e Alabama Veterans Program . . . . . . . . . . . . . . . . . . . . . . .

o Cancer Research Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

00

f Alabama Indian Children’s Scholarship Fund. . . . . . . . . .

p Alabama Alternative Fuels Fund . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

00

g Penny Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Alabama Military Support Foundation . . . . . . . . . . . . . . . . . . . . .

•

00

h Foster Care Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Alabama Veterinary Medical Foundation

•

00

00

i Mental Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Spay-Neuter Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

•

00

00

j Neighbors Helping Neighbors . . . . . . . . . . . . . . . . . . . . . .

s Alabama Association of Rescue Squads . . . . . . . . . . . . . . . . . . .

•

00

2 Total Donations. Add lines 1a, b, c, d, e, f, g, h, i, j, k, l, m, n, o, p, q, r, and s. Enter here and on Form 40, page 1, line 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedules B, CR, & DC (Form 40) 2012

ADOR