Form Ri-1040x-R - Amended Rhode Island Resident Individual Income Tax Return - 2012
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5Amended Rhode Island Resident Individual Income Tax Return
RI-1040X-R
2012
(To be used by resident taxpayers only)
First name
Initial
Last name
Your social security number
NAME AND
ADDRESS
Initial
Last name
Spouse’s social security number
Spouse’s first name
Present home address (number and street, including apartment no. or rural route)
Daytime telephone number
Please
(
)
print or type
City or town of legal residence
City, town or post office
State
ZIP code
A.
Enter name and address used on original return (if same as above write “SAME”)
ADDITIONAL
INFORMATION
B.
Are you filing an amended federal income tax return? ...................................................................................
Yes
C.
Have you been advised your federal return is under examination? ...............................................................
Yes
D.
On original return
FILING
1. Single
2. Married filing jointly
3. Married filing separately
4. Head of Household
5. Qualifying widow(er)
STATUS
E.
On this return
1. Single
3. Married filing separately
4. Head of Household
5. Qualifying widow(er)
2. Married filing jointly
INCOME AND TAX
A. Originally reported
B. Net change
C. Correct amount
1.
Federal AGI (Adjusted Gross Income)........................................................
1.
Single
$7,800
2.
Modifications from RI-1040, Schedule M, line 3.........................................
2.
Married
3.
3.
Modified Federal AGI. Combine lines 1 and 2..........................................
filing jointly
or
4.
Deductions
(see
instructions).....................................................................
4.
Qualifying
widow(er)
5.
Subtract line 4 from line 3...........................................................................
5.
$15,600
6.
Exemptions. Enter the number of federal exemptions
Married
claimed on this return in the box then multiply by
6.
filing
$3,650 and enter the result on line 6, column C.
separately
7.
RI Taxable Income. Subtract line 6 from line 5.........................................
7.
$7,800
Head of
8.
RI income tax from RI Tax Table or Tax Computation Worksheet..............
8.
household
9A.
$11,700
RI percentage of allowable federal credit from RI-1040, page 2, line 22...
9A.
9B.
RI credit for income tax paid to other states from RI-1040, page 2, line 29..
9B.
9C.
Other RI credits from RI-1040, Schedule CR, line 4..................................
9C.
9D.
Total RI credits. Add lines 9A, 9B and 9C.................................................
9D.
10A.
RI income tax after credits. Subtract line 9D from line 8
(not less than 0)
10A.
10B.
Recapture of Prior Year Other Rhode Island Credits, Schedule CR, line 7
10B.
11.
RI checkoff contributions from RI-1040, page 2, line 37............................
11.
12.
USE/SALES tax due from Consumer’s Use Tax Worksheet, page 4, line 5
12.
13.
Total RI Tax and checkoff contributions. Add lines 10A, 10B, 11 and 12..
13.
PAYMENTS
14. A. RI 2012 income tax withheld from Schedule W, line 21.....................
14A.
B.
2012 estimated tax payments and 2011 carryforward .......................
14B.
Attach
only the
14C.
C.
Property tax relief credit from Form RI-1040H....................................
supporting
forms and
14D.
D.
RI Earned Income Credit....................................................................
schedules
14E.
E.
Residential lead abatement income tax credit from Form RI-6238 ...
for the
items
F.
Other Payments ........................................................................................................................................................
14F.
changed.
G.
Total. Add lines 14A, 14B, 14C, 14D, 14E and 14F..................................................................................................
14G.
H.
Overpayment allowed on original return ...................................................................................................................
14H.
I.
Total payments after overpayment. Subtract line 14H from 14G .............................................................................
14I.
AMOUNT
15. A. If line 13 is larger than 14I, subtract line 14I from 13. This is the amount you owe......................................
15A.
DUE
B.
Interest due on amount on line 15A ...............................................................................................................
15B.
C.
Total balance due. Add lines 15A and 15B ...................................................................................................
15C.
REFUND
16. If line 14I is larger than line 13, subtract line 13 from 14I. This is the amount you overpaid...............................
16.
☺
17.
17.
Amount of overpayment to be refunded ...............................................................................................................
18.
18.
Amount of overpayment to be applied to 2013 estimated tax ..............................................
RETURN MUST BE SIGNED - SIGNATURE LINE IS LOCATED ON PAGE 2
Mail returns to: RI Division of Taxation - One Capitol Hill - Providence, RI 02908-5806
page 1
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