Fillable Form N-103 - Sale Of Your Home - 2014 printable pdf download

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STATE OF HAWAII — DEPARTMENT OF TAXATION

FORM

SALE OF YOUR HOME

N-103

2014

SEE SEPARATE INSTRUCTIONS. ATTACH TO FORM N-11 OR N-15.

(REV. 2014)

(NOTE: References to “married”, “unmarried”, and “spouse” also means “in a civil union”, “not in a civil union”, and “civil union partner”, respectively.)

Your first name and initial

Last name

Your social security number

If a joint return, spouse’s first name and initial

Last name

Spouse’s social security number

Present mailing or home address (Number and street, including apartment number or rural route)

Fill in your address

if you are filing this

form by itself and

City, town or post office, State, and Postal/ZIP code

not with your tax

return

General Information

PART I

Date your former main home was sold (month, day, year) .......................................................................................



Was any part of your main home rented out or used for business? (If “Yes,” see Instructions) .....................................................

Yes



Was your former residence purchased with funds from an Individual Housing Account? .............................................................

Yes

(If “Yes,” go to line 4; if “No,” go to line 8.)

When was your former residence purchased? (month, day, year) ............................................................................

Amount of distribution from your Individual Housing Account used to purchase your former home. .....................

Amount of line 5 not previously reported. (See Instructions.) If line 6 is zero, go to line 8. If line 6 is more than zero,

include this amount on Form N-11, line 10, or Form N-15, line 19, and go to line 7. ....................................................................

Enter 10% (.10) of line 5. (See Instructions for where to include this amount on Form N-11 or N-15) ..................

Gain or (Loss), Exclusion, and Taxable Gain

PART II

Selling price of home. (Do not include personal property items that you sold with your home.) ............................

Selling expenses (including commissions, advertising and legal fees, and seller-paid loan charges) ..................

Amount realized. Line 8 minus line 9. ....................................................................................................................

Adjusted basis of home sold. (See Instructions) ....................................................................................................

Gain or (loss) on the sale. Line 10 minus line 11. If this amount is zero or less, stop here. .................................

Enter any depreciation allowed or allowable on the property for periods after May 6, 1997. If none, enter -0-. ....

Line 12 minus line 13. If the result is less than zero, enter -0-. ..............................................................................

Aggregate number of days of nonqualified use after 2008. If none, enter -0-.

If line 15 is equal to zero, skip to line 19 and enter the amount from line 14 on line 19. ........................................

Number of days taxpayer owned the property. .......................................................................................................

Divide the amount on line 15 by the amount on line 16. Enter the result as a decimal (rounded to at least 3

places). Do not enter an amount greater than 1.00. ..............................................................................................

Gain allocated to nonqualified use. Line 14 multiplied by line 17. ..........................................................................

Gain eligible for exclusion. Line 14 minus line 18...................................................................................................

If you qualify to exclude gain on the sale, enter your maximum exclusion. (See Instructions) If you qualify for a

reduced maximum exclusion, enter the amount from the Reduced Maximum Exclusion Worksheet in federal

Publication 523. If you do not qualify to exclude gain, enter -0-. ............................................................................

Exclusion. Enter the smaller of line 19 or line 20. ................................................................................................

Taxable gain. Line 12 minus line 21. (See Instructions for where to report your taxable gain.) ............................

I declare, under the penalties set forth in section 231-36, HRS, that I have examined this form, including attachments, and to the best of my knowledge

Sign here if you

and belief, it is true, correct, and complete.

are filing

this form by itself



and not

with your tax

Your signature

Date

Spouse’s signature

Date

return