Form It-540b - Louisiana Nonresident And Part-Year Reside - 2013 Page 2
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102013 LOUISIANA NONRESIdENT
IMPORTANT!
IMPORTANT!
IT-540B WEB
You must enter your SSN below in the same
ANd PART-yEAR RESIdENT
order as shown on your federal return.
Mark Box:
Your first name
Init. Last name
Suffix
Name
Your
Change
SSN
If joint return, spouse’s name
Init. Last name
Suffix
Decedent
Spouse’s
Filing
SSN
Present home address
(number and street including apartment number or rural route)
Spouse
Decedent
Area code and daytime telephone number
City, Town, or APO
State
ZIP
Amended
Return
NOL
Carryback
Your Date of Birth
Spouse’s Date of Birth
(mmddyyyy)
(mmddyyyy)
FILING STATUS: Enter the appropriate number in the
6 EXEMPTIONS:
filing status box. It must agree with your federal return.
65 or
X
6A
Yourself
Blind
a “1” in box if single.
Enter
older
Total of
a “2” in box if married filing jointly.
Enter
6A & 6B
65 or
6B
Spouse
Blind
a “3” in box if married filing separately.
older
Enter
a “4” in box if head of household.
Enter
If the qualifying person is not your dependent, enter name here.
a “5” in box if qualifying widow(er).
Enter
6C dEPENdENTS – Enter dependent information below. If you have more than 6 dependents, attach a statement to your return with the
required information. Enter the total number from Federal Form 1040A, Line 6c, or Federal Form 1040, Line 6c, in the boxes here.
6C
First Name
Last Name
Social Security Number
Relationship to you
Birth Date
(mm/dd/yyyy)
6D TOTAL EXEMPTIONS – Total of 6A, 6B, and 6C
6d
6482
WEB
64824
66
12312013
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