Form N-15 - Individual Income Tax Return - Nonresident And Part-Year Resident Page 4
Download a blank fillable Form N-15 - Individual Income Tax Return - Nonresident And Part-Year Resident in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form N-15 - Individual Income Tax Return - Nonresident And Part-Year Resident with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4Form N-15 (Rev. 2012)
Page 4 of 4
Your Social Security Number
Your Spouse’s SSN
Name(s) as shown on return
JCF124
If negative number, place a minus sign (-)
-
52
Line 50 minus line 51 ................................................................................................. Balance
† 52
53
Hawaii State Income tax withheld (attach W-2s)
53
(see page 31 of the Instructions for other attachments) ...
54
2012 estimated tax payments on
54
Forms N-1 _____________ ; N-288A _____________ ..
55
55
Amount of estimated tax applied from 2011 return .................
56
56
Amount paid with extension...............................................
57
Add lines 53 through 56 ................................................................................. Total Payments
† 57
58
If line 57 is larger than line 52, enter the amount OVERPAID (line 57 minus line 52) (see Instructions) ..
58
59
Contributions to (see page 31 of the Instructions): ........................
Yourself
Spouse
59a Hawaii Schools Repairs and Maintenance Fund .....................
$2
$2
ID NO 01
59b Hawaii Public Libraries Fund ...................................................
$2
$2
59c Domestic and Sexual Violence / Child Abuse and Neglect Funds .............
$5
$5
60
60
Add the amounts of the Xs on lines 59a through 59c and enter the total here .............................
61
61
Line 58 minus line 60 ....................................................................................................................
62
Amount of line 61 to be applied to
your 2013 ESTIMATED TAX..............................................
62
63a
Amount to be REFUNDED TO YOU (line 61 minus line 62) If filing late, see page 32 of Instructions. Place an X here
if this refund will
ultimately be deposited to a foreign (non-U.S.) bank. Do not complete lines 63 b, c, or d.
b
c Type:
Routing number
Checking
Savings
d
63a
Account number
.................................
64
AMOUNT YOU OWE (line 52 minus line 57). Send Form N-200V with your payment.
64
Make check or money order payable to the “Hawaii State Tax Collector” ......................................
65
Estimated tax penalty. (See page 32 of Instr.) Do not include this amount in line
58 or 64. Place an X in this box if Form N-210 is attached
†
65
If negative number, place a minus sign (-)
-
66
AMENDED RETURN ONLY - Amount paid (overpaid) on original return. (See Instructions) (attach Sch. AMD) .........
66
If negative number, place a minus sign (-)
-
67
AMENDED RETURN ONLY - Balance due (refund) with amended return. (See Instructions) (attach Sch. AMD) ......
67
If designating another person to discuss this return with the Hawaii Department of Taxation, complete the following. This is not a full power of
attorney. See page 33 of the Instructions.
†
†
†
Designee’s name
Phone no.
Identification number
HAWAII ELECTION
Â
Note: Placing an X in the “Yes”
Do you want $3 to go to the Hawaii Election Campaign Fund?
Yes
No
box will not increase your tax
CAMPAIGN FUND
If joint return, does your spouse want $3 to go to the fund?
Yes
No
or reduce your refund.
DECLARATION — I declare, under the penalties set forth in section 231-36, HRS, that this return (including accompanying schedules or statements) has been examined by me and, to the best
of my knowledge and belief, is a true, correct, and complete return, made in good faith, for the taxable year stated, pursuant to the Hawaii Income Tax Law, Chapter 235, HRS.
Spouse’s signature (if filing jointly, BOTH must sign)
Your signature
Date
Date
†
†
Your Occupation
Daytime Phone Number
Your Spouse’s Occupation
Daytime Phone Number
Date
Preparer’s identification number
Paid
Preparer’s
Check if
†
o
†
Preparer’s
Signature
self-employed
Information
Print
†
†
Federal E.I. No.
Preparer’s Name
Firm’s name (or yours
†
†
Phone No.
if self-employed),
Address, and ZIP Code
FORM N-15
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial