Schedule 1 Form 1040me - Income Modifications - 2012
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1
2SCHEDULE 1
INCOME MODIFICATIONS
FORM 1040ME
2012
See instructions on pages 3 and 4.
99
Enclose with your Form 1040ME
Attachment
For more information, visit
*1202203*
2
Sequence No.
Name(s) as shown on Form 1040ME
Your Social Security Number
SCHEDULE 1 — INCOME MODIFICATIONS - For Form 1040ME, line 15
1 ADDITIONS to federal adjusted gross income.
.00
a
Income from municipal and state bonds, other than Maine ...................................................1a
.00
b
Net Operating Loss Recovery Adjustment (Attach a schedule showing your calculation) ....1b
.00
c
Maine Public Employees Retirement System Contributions .................................................1c
.00
d
Domestic Production Activities Deduction Add-back (See instructions) ................................1d
.00
e
Bonus Depreciation Add-back (See instructions) ..................................................................1e
.00
f
Maine Capital Investment Credit Bonus Depreciation Add-back ...............................................1f
.00
g
Fiduciary Adjustment - additions only (Attach a copy of your federal Schedule K-1) ............1g
h
Other (See instructions). List the type and amount of income items included (Attach
.00
supporting documentation) ______________________________________ ....................1h
.00
i
Total additions (Add lines 1a through 1h) ...............................................................................1i
2
SUBTRACTIONS from federal adjusted gross income.
.00
a
U.S. Government Bond interest included in federal adjusted gross income (See instructions) ..2a
.00
b
State Income Tax Refund (Only if included in federal adjusted gross income) .....................2b
c
Social Security and Railroad Retirement Benefi ts included in federal adjusted gross
.00
income (See instructions) ......................................................................................................2c
.00
d
Pension Income Deduction (Complete and attach the worksheet on back) ..........................2d
e
Interest from Maine Municipal General Obligation, Private Activity and Airport Authority
.00
Bonds included in federal adjusted gross income (See instructions) ....................................2e
f
Premiums for Long-Term Care Insurance (Do not include health insurance premiums on this line)
.00
NOTE: If you itemize deductions or are self-employed, complete and attach the worksheet on back ....2f
g
Maine Public Employees Retirement System Pick-Up Contributions paid to the taxpayer
.00
during 2012 which have been previously taxed by the state .................................................2g
.00
h
Contributions to Qualifi ed Tuition Programs - 529 Plans (See instructions) ..........................2h
.00
i
Fiduciary Adjustment - subtractions only (Attach a copy of your federal Schedule K-1) ........2i
.00
j
Bonus Depreciation and Section 179 Recapture (See instructions) ......................................2j
.00
k
Other. List ___________________________________________ (See instructions) .......2k
(Do not enter non-Maine source income on line 2k)
.00
l
Total Subtractions (Add lines 2a through 2k) ..........................................................................2l
3
Net Modifi cation (Subtract line 2l from line 1i — enter here and on 1040ME, page 1, line 15)
.00
(If negative, enter a minus sign in the box to the left of the number) ...................................3
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