Illinois Department of Revenue
2013 Form IL-1040-X
Amended Individual Income Tax Return
REV 12
Step 1: Personal information
Do not write above this line.
A
Print or type your current Social Security number(s), name(s), and address.
–
–
–
–
Your Social Security number
Spouse’s Social Security number
Your first name and initial
Spouse’s first name and initial (and last name - only if different)
Your last name
Mailing address
Apt. number
City
State
ZIP or Postal Code
Foreign Nation, if not U.S.A.
B
Check if your Social Security number(s), name(s), or address listed above are different from your previously filed return.
C
Filing Status:
Single or head of household
Married filing jointly
Married filing separately
Widowed
D
Residency:
Resident
Nonresident
Part-year resident
E
Check if you are in a civil union (see instructions)
F
**
Check the box that identifies why you are making this change.
Attach a copy of your federal finalization. (see instructions)
____ ___ ____
____ ____ ____
**
**
Federal change accepted on
NOL accepted on
State change
Month
Day
Year
Month
Day
Year
Step 2: Reason for filing
If you are changing your Illinois return due to a change to your federal return that resulted in an overpayment, do not file this form
until you receive notification that the Internal Revenue Service (IRS) accepted the changes.
______/______/______
G
On what date did you file your original Form IL-1040 or your latest Form IL-1040-X?
H
Did you file a U.S. Form 1040X or Form 1045? If "yes," you must attach a copy to this form (see instructions).
yes
no
I
Explain, in detail, the reason(s) for filing this amended return. Attach a separate sheet if necessary.
Step 3: Financial information
Column A
Column B
Line numbers may not match your original return.
As originally reported or adjusted
Corrected figures
1
1
1
Federal adjusted gross income
.00
.00
2
2
2
Federally tax-exempt interest and dividend income
.00
.00
3
3
3
Other additions (attach Schedule M with amended figures)
.00
.00
4
4
4
Total income – Add Lines 1 through 3.
.00
.00
5
Social Security benefits and certain retirement plan income (attach U.S.
5
5
1040 or 1040A, page 1 with amended figures)
.00
.00
6
Illinois Income Tax overpayment included in U.S. 1040, Line 10 (attach
6
6
U.S. 1040, page 1 with amended figures)
.00
.00
7
7
7
Other subtractions (attach Schedule M with amended figures)
.00
.00
8
8
8
Total subtractions. Add Lines 5 through 7.
.00
.00
9
9
9
Illinois base income. Subtract Line 8 from Line 4.
.00
.00
10
Number of exemptions:
a
10a
10a
yourself and your dependents
X $2,100
.00
.00
b
10b
10b
65 or older or legally blind
X $1,000
.00
.00
c
10c
10c
Add Lines 10a and 10b. This is your exemption allowance.
.00
.00
11
11
11
Residents only: Net income. Subtract Line 10c from Line 9.
.00
.00
12
Nonresidents and part-year residents only: Write your Illinois base
12
12
income from Schedule NR. (attach Schedule NR with amended figures)
.00
.00
13
Residents: Multiply Line 11 by 5% (.05).
13
13
Nonresidents and part-year residents: Write the tax from Schedule NR.
.00
.00
14
14
14
Recapture of investment tax credits (attach Schedule 4255)
.00
.00
15
15
15
Income tax. Add Lines 13 and 14.
.00
.00
*361501110*
Official Use
IL-1040-X (R-12/13)
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