Form 511nr - Oklahoma Nonresident/part-Year Income Tax Return - 2011 Page 2
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2011 Form 511NR - Nonresident/Part-Year Income Tax Return - Page 2
Name(s) shown
Your Social
on Form 511NR:
Security Number:
00
Adjusted gross income: All Sources (from page 1, line 24) ..................................
25
25
Oklahoma
Oklahoma Adjustments (Schedule 511NR-C, line 8) ...............................................
00
Standard
26
NR-C
26
00
Income after adjustments (line 25 minus line 26) ....................................................
Deduction:
27
27
00
• Single or
Oklahoma standard or Federal itemized deductions .........
28
28
Married Filing
00
29
Exemptions
....
($1,000 x number of exemptions claimed on page 1)
29
Separate:
00
Total deductions and exemptions (add lines 28-29) ................................................
30
30
$5,800
00
31
Oklahoma Taxable Income: (line 27 minus line 30) ..............................................
31
• Married
Oklahoma Income Tax from Tax Table.....................................................................
32
Filing Joint
32
If using Farm Income Averaging, enter tax from Form 573, line 22 and enter a “1” in box.
or Qualifying
If paying the Health Savings Account additional 10% tax, add additional tax here and enter a “2” in box.
00
Widow(er):
STOP AND READ: If line 24 is equal to or larger than line 19, complete line 33. If line 24 is smaller than line 19, see Schedule 511NR-D.
$11,600
Oklahoma child care/child tax credit (see instructions) ...........................................
00
• Head of
33
NR-D
33
Subtract line 33 from line 32 (This is your tax base) ...............................................
00
Household:
34
34
$8,500
Tax percentage:
Oklahoma Amount (from line 23)
Federal Amount (from line 24)
•
35
%
a)
b)
•
35
Itemized
00
Oklahoma Income Tax. Multiply line 34 by line 35 ................................................
36
36
Deductions:
00
Credit for taxes paid to another state (enclose Form 511TX)
37
nonresidents do not qualify
37
Enclose a
copy of the
Form 511CR - Other Credits Form -
List 511CR line number claimed here:
38
38
00
Federal
Line 36 minus lines 37 and 38 (Do not enter less than zero) ..................................
00
Schedule
39
39
Use Tax. Check here if no use tax is due:
....................................................
00
40
40
If filing an
Business Activity Tax (enclose Form 511-BAT) .......................................................
00
41
41
amended
00
Balance (add lines 39, 40 and 41) ...........................................................................
42
42
return,
00
Oklahoma withholding
43
(enclose W-2s, 1099s or withholding statement) .
43
complete
WORKSHEET
2011 Oklahoma estimated tax payments ..........................
44
worksheet
44
on page 5 of
00
If you are a qualified farmer, check here:
Form 511NR.
00
2011 payment with extension ............................................
45
45
Oklahoma earned income credit (Sch. 511NR-E, line 4) ...
00
46
NR-E
46
Total payments and credits (add lines 43-46) ......................................................
00
47
47
For further
If line 47 is more than line 42, subtract line 42 from line 47. This is your overpayment .
00
48
48
information
Amount of line 48 to be applied to 2012 estimated tax .....
00
49
49
regarding
Donations from your refund
..
(Sch. 511NR-F, line 13)
00
50
50
estimated tax,
00
Total deductions from refund (add lines 49 and 50) ................................................
see page 4 of
51
51
instructions.
Amount to be refunded (line 48 minus line 51).......................................................
00
52
52
Direct Deposit Note:
Is this refund going to or through an account that is located outside of the United States?
Yes
No
Deposit my refund in my:
For Direct Deposit Information see the
instructions. If you do not have your refund
Routing
checking account
deposited directly into your bank account,
Number:
you will receive a debit card. For debit card
Account
information see “All About Refunds” in the
savings account
Number:
instructions.
If line 42 is more than line 47, subtract line 47 from line 42. This is your tax due ..
00
53
53
00
Donation: Eastern Red Cedar Revolving Fund.
$2
$5
$ _________
54
54
Underpayment of estimated tax interest .....
.....
00
(annualized installment method
)
55
55
00
Delinquent payment (add penalty of 5% plus interest at 1.25% per month) ....
56
56
00
Total tax, donation, penalty and interest (add lines 53-56) ..............................
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57
Under penalty of perjury, I declare the information contained in this document, and all
Check this box if the Oklahoma Tax Commission
attachments and schedules, is true and correct to the best of my knowledge and belief.
may discuss this return with your tax preparer.....
Taxpayer’s signature
Date
Spouses’s signature
Date
Paid Preparer’s signature
Date
Paid Preparer’s address and phone number
Taxpayer’s occupation
Spouse’s occupation
Daytime Phone Number (optional)
A COPY OF FEDERAL RETURN
Paid Preparer’s
MUST BE PROVIDED.
ID Number
Please remit to: Oklahoma Tax Commission, P.O. 26800, Oklahoma City, OK 73126-0800
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