Form Ri-1040nr - Rhode Island Nonresident Individual Income Tax - 2012

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RI-1040NR
2012
RHODE ISLAND NONRESIDENT INDIVIDUAL INCOME TAX
RETURN (
FOR NONRESIDENTS AND PART-YEAR RESIDENTS)
Your first name
Initial
Last name
Your social security number
NAME
AND
ADDRESS
Spouse's first name
Initial
Last name
Spouse’s social security number
Present home address (number and street, including apartment number or rural route)
Daytime telephone number
please print
or type
(
)
City, town or post office
State
ZIP code
City or town of legal residence
If you want $5.00 ($10.00 if a joint return) to go
If you wish the 1st $2.00 ($4.00 if a joint return) to be paid to a
ELECTORAL
Yes
to this fund, check here. (See instructions. This
specific party, check the box and fill in the name of the political
CONTRIBUTION
will not increase your tax or reduce your refund.)
party. Otherwise, it will be paid to a nonpartisan general account.
FILING
Check only
1
2
3
4
5
STATUS
one box
Single
Married filing jointly
Married filing separately
Head of household
Qualifying widow(er)
INCOME,
1.
Federal AGI (Adjusted Gross Income) from Federal Form 1040, line 37; 1040A, line 21 or 1040EZ, line 4................
1.
TAX AND
2.
Net modifications to Federal AGI from RI Schedule M, line 3. If no modifications, enter zero on this line..................
2.
CREDITS
3.
Modified Federal AGI. Combine lines 1 and 2 (add net increases or subtract net decreases)....................................
3.
4.
Deductions. RI standard deduction (left margin).
4.
If line 3 is over $181,900, see Standard Deduction Worksheet on page i.
Rhode Island
Standard
5.
Subtract line 4 from line 3..............................................................................................................................................
5.
Deduction
6.
Exemptions. Enter federal exemptions in box then multiply by $3,650 and enter result in 6.
X $3,650 =
6.
Single
......
If line 3 is over $181,900, see Exemption Worksheet on Exemption Worksheet on page i ...............
$7,800
7.
RI TAXABLE INCOME. Subtract line 6 from line 5......................................................................................................
7.
Married filing
jointly or
8.
RI income tax from Rhode Island Tax Table or Tax Computation Worksheet ..............................................................
8.
Qualifying
widow(er)
9.
RI percentage of allowable Federal credit from page 2, RI Schedule I, line 25 ..........................................................
9.
$15,600
Married filing
10.
Rhode Island tax after allowable Federal credit - before allocation. Subtract line 9 from line 8 (not less than zero)
10.
separately
$7,800
A
N
P
11.
ll income is from RI,
onresident with income from outside
art-year resident with income from
RI allocated
Head of
11.
income tax.
household
enter amount from line
RI, complete page 7, schedule II and
outside RI, complete page 9, schedule
Check one box
$11,700
10 on this line.
enter result on this line.
III and enter result on this line.
12.
Other Rhode Island Credits from RI Schedule CR, line 4 ............................................................................................
12.
13.
A.
RI income tax after credits. Subtract line 12 from line 11 (not less than zero)......................................................
13A.
Attach Forms
B.
Recapture of Prior Year Other Rhode Island Credits from RI Schedule CR, line 7...............................................
13B.
W-2 and
1099 here.
14.
RI checkoff contributions from page 2, RI Checkoff Schedule, line 33
14.
(Contributions reduce your refund or increase your balance due.)
15.
USE/SALES tax due from page I-4, line 6 of the Individual Consumer’s Use/Sales Tax Worksheet ..........................
15.
16.
TOTAL RI TAX AND CHECKOFF CONTRIBUTIONS. Add lines 13A, 13B, 14 and 15 .............................................
16.
A.
17.
R h o d e I s l a n d 2 0 1 2 i n c o m e ta x w i t h h e l d f r o m R I S c h e d u l e W, l i n e 2 1 . . .
17A.
(All Forms W-2 and 1099 with RI withholding, AND Schedule W must be attached)
Check
if
B.
2012 estimated tax payments and amount applied from 2011 return..........................
17B.
extension is
PAYMENTS
attached.
C.
Nonresident withholding on real estate sales in 2012 .................................................
17C.
D.
RI earned income credit from page 2, RI Schedule EIC, line 42.................................
17D.
E.
Other payments............................................................................................................
17E.
F.
TOTAL PAYMENTS AND CREDITS. Add lines 17A, 17B, 17C, 17D and 17E ....................................................
17F.
AMOUNT
18.
A.
AMOUNT DUE: If line 16 is LARGER than line 17F, subtract line 17F from 16 .........
18A.
DUE
Check
if RI-2210 or RI-2210A is attached and enter underestimating interest due.
B.
18B.
This amount should be added to line 18A or subtracted from line 19, whichever applies.
C.
TOTAL AMOUNT DUE. Add lines 18A and 18B. Complete RI-1040V and send in with your payment ......
18C.
19.
AMOUNT OVERPAID. If line 17F is LARGER than 16, subtract line 16 from 17F.............................................
19.
REFUND
If there is an amount due for underestimating interest on line 18B, subtract line 18B from line 16.
20.
Amount of overpayment to be refunded........................................................................................................................
20.
21.
Amount of overpayment to be applied to 2013 estimated tax............................................
21.
RETURN MUST BE SIGNED - SIGNATURE LINE IS LOCATED ON PAGE 2
MAILING ADDRESS: RI Division of Taxation - One Capitol Hill - Providence, RI 02908-5806

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