MONTANA
Clear Form
AMD Worksheet
Rev 03 12
Montana Individual Income Tax
Amended Return Reconciliation Worksheet
Social Security Numbers
Your First Name and Initial
Last Name
-
-
X X X X X X X X X
Spouse’s First Name and Initial
Last Name
-
-
X X X X X X X X X
Y Y Y Y
Tax year amending
X X X X
As Filed or
Income and Deductions
Net Change
As Amended
Last Adjusted
1. Federal adjusted gross income (AGI) ................................................ 1.
2. Montana additions to federal adjusted gross income ........................ 2.
3. Montana subtractions from federal adjusted gross income ............... 3.
4. Montana adjusted gross income (add lines 1 and 2, then
subtract line 3) ................................................................................... 4.
5. Deductions (standard or itemized)..................................................... 5.
6. Exemption(s) amount ........................................................................ 6.
7. Taxable income (add lines 5 and 6, then subtract from line 4) .......... 7.
Tax Liability
8. Tax ..................................................................................................... 8.
9. Tax on lump sum distributions ........................................................... 9.
10. Add lines 8 and 9 and enter the result here..................................... 10.
11. Capital gains tax credit .....................................................................11.
12. Nonrefundable tax credits................................................................ 12.
13. Subtract lines 11 and 12 from line 10 and enter the result here ...... 13.
14. Recapture tax(es) ............................................................................ 14.
15. Voluntary check-off contribution programs ...................................... 15.
16. Add lines 13 through 15 and enter the result here .......................... 16.
17. Montana income tax withheld .......................................................... 17.
18. Other income tax withheld, including any mineral royalty tax or
tax withheld for you by a pass-through entity .................................. 18.
19. Estimated and extension payments................................................. 19.
20. Refundable credits........................................................................... 20.
21. Tax paid with original return plus subsequent payments (tax
only, do not include payments of penalty and interest) .................... 21.
22. Total refund(s) previously received for year amending .................... 22.
23. Add lines 17 through 21, then subtract line 22 and enter the
result here........................................................................................ 23.
24. Refund. If line 23 is greater than line 16, enter the difference here .. 24.
25. Tax Due. If line 23 is less than line 16, enter the difference here ... 25.
The AMD Worksheet does not serve as an amended return on its own. When you file an amended tax return, you will need to complete
a new tax return that reflects the corrections you are making.
*12CW0101*
*12CW0101*