Schedule A (Form 40) - Itemized Deductions, Schedule B - Interest And Dividend Income, Schedule Dc - Donation Check-Offs - 2013 Page 2

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130004401283

Sch. A, B, & DC

(Form 40) 2013

Page 2

Name(s) as shown on Form 40 (Do not enter name and social security number if shown on other side)

Your social security number

SCHEDULE B – Interest And Dividend Income

If you received more than $1500 of interest and dividend income, you must complete Schedule B. See instructions on page 21.

List Payers and Amounts

Taxable Interest

Exempt Interest

and Dividends

TOTAL TAXABLE INTEREST AND DIVIDENDS

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Enter here and on Form 40, page 1, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SCHEDULE DC – Donation Check-Offs

1 You may donate all or part of your overpayment. (Enter the amount in the appropriate boxes.)

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a Senior Services Trust Fund . . . . . . . . . . . . . . . . . . . . . . .

j Alabama Firefighters Annuity and Benefit Fund . . . . . . . . . . . .

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b Alabama Arts Development Fund . . . . . . . . . . . . . . . . . .

k Alabama Breast & Cervical Cancer Program . . . . . . . . . . . . . .

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c Alabama Nongame Wildlife Fund . . . . . . . . . . . . . . . . . .

l Victims of Violence Assistance . . . . . . . . . . . . . . . . . . . . . . . .

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d Child Abuse Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . .

m Alabama Military Support Foundation. . . . . . . . . . . . . . . . . . . . .

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e Alabama Veterans Program . . . . . . . . . . . . . . . . . . . . . . .

n Alabama Veterinary Medical Foundation

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f Alabama State Historic Preservation Fund . . . . . . . . . .

Spay-Neuter Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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g Archives Services Fund . . . . . . . . . . . . . . . . . . . . . . . . . .

o Cancer Research Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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h Foster Care Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Alabama Association of Rescue Squads . . . . . . . . . . . . . . . . . .

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i Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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2 Total Donations. Add lines 1a, b, c, d, e, f, g, h, i, j, k, l, m, n, o, and p. Enter here and on Form 40, page 1, line 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ADOR

Schedules B, & DC (Form 40) 2013