Form Pa-40 Schedule A (08-15) (Fi) - Pa-Taxable Interest Income - 2015

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1501210056
PA SCHEDULE A
Interest Income
PA-40 Schedule A
2015
(08-15) (FI)
OFFICIAL USE ONLY
START
Name shown first on the PA-40 (if filing jointly)
Social Security Number (shown first)
CAUTION: Federal and PA rules for taxable interest income are different. Read the instructions.
If your total PA-taxable interest income (taxpayer, spouse and/or joint) is equal to the amount reported on your federal return and you have
no amounts for Lines 2 through 15 (not including subtotal Lines 4 and 10) of PA Schedule A, you must report your income on Line 2
of the PA-40, but you do not have to submit PA Schedule A. If there are any amounts (taxpayer, spouse and/or joint) for any of the
Lines 2 through 15 (not including subtotal Lines 4 and 10) of the schedule, you must complete and submit PA Schedule A with your
PA-40. A taxpayer and spouse must complete separate schedules to report their income if any amounts are reported on Lines 2
through 15 (not including subtotal Lines 4 and 10) of Schedule A. However, if all the income is earned on a joint basis, one schedule
may be completed. Complete the oval to indicate whether the income included on the schedule is from the taxpayer, spouse or joint. If
a separate PA Schedule A is prepared for a taxpayer and spouse, include only the taxpayer or spouse share of the income for each line.
PA SCHEDULE A - PA-Taxable Interest Income
(See the instructions.)
Taxpayer
Spouse
Joint
PA-40 A (08-15)
1. $
1. Interest income reported on your federal return. See instructions.
2. $
2. Tax-exempt interest income reported on Line 8b of your federal return.
3. Other addition adjustments. See instructions.
3. $
Description:
4. $
4. Add Lines 1, 2 and 3.
5. $
5. Interest income from federal Schedule(s) K-1. See instructions.
6. Interest income from direct obligations of the Commonwealth of Pennsylvania
6. $
and/or its municipalities.
7. $
7. Interest income from direct obligations of the U.S. government.
8. Other reduction adjustments. See instructions.
8. $
Description:
9. $
9. Add Lines 5, 6, 7 and 8.
10. $
10. Subtract Line 9 from Line 4.
11. Distributions from Life Insurance, Annuity or Endowment Contracts included in
11. $
federal taxable income.
12. $
12. Distributions from Charitable Gift Annuities included in federal taxable income.
13. Distributions from IRC Section 529 Qualified Tuition Programs for
13. $
non-educational purposes.
14. Distributions from Health/Medical Savings Accounts included in federal
14. $
taxable income.
15. Interest income from PA S corporations and partnership(s), reported on your
15. $
PA Schedule(s) RK-1 or federal Schedule(s) K-1.
16. $
16. Total PA-Taxable Interest Income. Add Lines 10 through 15. Enter on Line 2 of your PA-40.
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1501210056
1501210056

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