Form 511nr - Oklahoma Nonresident/ Part-Year Income Tax Return - 2012 Page 7
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42Top of Form Instructions
A
#1695#
Form 511NR - 2012
Oklahoma Nonresident/
Part-Year Income Tax Return
AMENDED
Your Social Security Number
Place an ‘X’ in this box
RETURN!
B
if this taxpayer
If filing an Amended Return,
enclose a copy of your
is deceased
Federal Amended Return
Spouse’s Social Security Number
and IRS acceptance.
Place an ‘X’ in this box
Place an ‘X’ in this box
(joint return only)
B
if this is an
if this taxpayer
amended
is deceased
511NR:
Your first name, middle initial and last name
If a joint return, spouse’s first name, middle initial and last name
C
F
Mailing address (number and street, including apartment number, rural route or PO Box)
Not Required to File
Place an ‘X’ in this box if you do not have an Oklahoma filing
City, State and Zip
requirement and are filing for refund of State withholding.
(see instructions)
1
Single
* NOTE: If claiming Special Exemption, see instructions on page 8 of 511NR Packet.
2
Married filing joint return
*
(even if only one had income)
Regular
Special
Blind
3
Married filing separate
D
Add the Totals from
=
Yourself
+
+
the 4 boxes.
G
• If spouse is also filing,
Write the Total
in the box below.
list SSN and name in box:
+
+
Total
=
Spouse
4
Head of household with qualifying person
=
5
Qualifying widow(er) with dependent child
=
Number of dependent children
• Please list the year spouse died in box at right:
Note: If you may
be claimed as a
dependent on another
=
return, enter “0”
Number of other dependents
E
Nonresident(s) State of Residence: ________________
for your regular
H
exemption.
Part-Year Resident(s) From ___________ to _________
Resident/Part-Year Resident/Nonresident
Yourself
Spouse
Age 65 or Over?
(Please see instructions)
State of Residence: Yourself _________ Spouse _______
Please Round to Nearest Whole Dollar
A
D
Begin Here
Do Not Write in this Space
Filing Status
to arrive at Oklahoma Adjusted Gross Income. Lines 1-19: In the Federal column, enter the amounts from your Federal Tax Return.
See the instructions to figure the amounts to report in the Oklahoma column.
Federal Amount
Oklahoma Amount
The barcode near the form number contains a page
The filing status for Oklahoma purposes is the same as
00
00
Wages, salaries, tips, etc ..............................................................
1
notation signifying the first page of a new return for pro-
1
on the Federal income tax return, with one exception.
00
00
Taxable interest income ................................................................
2
2
cessing equipment use. The blank area is used for pro-
This exception applies to married taxpayers who file a
Dividend income ...........................................................................
00
00
3
3
cessing notations. Please do not write in these areas.
joint federal return where one spouse is an Oklahoma
Taxable refunds (state income tax)...............................................
00
00
4
4
00
00
Alimony received ..........................................................................
resident (either civilian or military), and the other is a
5
B
5
00
00
Business income or (loss) (Federal Schedule C) .........................
Social Security Number
6
nonresident civilian (non-military). In this case the tax-
6
Capital gains or losses (Federal Schedule D) ..............................
00
00
7
payer must either:
7
Enter your Social Security Number. If you file married
Other gains or losses (Federal Form 4797)..................................
00
00
8
8
00
00
Taxable IRA distribution ................................................................
• File as Oklahoma married filing separate. The
filing joint, please enter your spouse’s Social Security
9
9
00
00
Taxable pensions and annuities ...................................................
10
Oklahoma resident, filing a joint Federal return with a
Number in the space provided.
10
Rental real estate, royalties, partnerships, etc .............................
00
00
11
nonresident civilian spouse, may file an Oklahoma return
11
Note: If you file married filing separate, do not enter your
Farm income or (loss) ...................................................................
00
00
12
12
as married filing separate. The resident will file on Form
spouse’s Social Security Number here. Enter it in item D.
00
00
Unemployment compensation ......................................................
13
13
511 using the married filing separate rates and reporting
00
00
Taxable Social Security benefits
.......
14
(also enter on line 2 of Sch. 511NR-B)
14
only his/her income and deductions. If the nonresident
Other income (identify: ________________________________)
00
00
15
What About Deceased Taxpayers?
15
Add lines 1 through 15..................................................................
civilian has an Oklahoma filing requirement, he/she will
00
00
16
16
00
00
Total Federal adjustments to income (identify: ______________)
If a taxpayer died before filing a return, the executor, ad-
file on Form 511NR, using married filing separate rates
17
17
Oklahoma source income (line 16 minus line 17)......................
00
18
ministrator or surviving spouse may have to file a return
and reporting his/her income and deductions. Form 574
18
Federal adjusted gross income (line 16 minus line 17) ............
00
19
for the decedent. Place an ‘X’ in the appropriate box in
19
“Allocation of Income and Deductions” must be filed with
Oklahoma additions: Schedule 511NR-A, line 8 ..........................
00
00
20
20
the SSN area.
the return(s). You can obtain this form from our website
Add lines (Federal 19 and 20) and then (Oklahoma 18 and 20) ..
00
00
21
21
at
00
00
Oklahoma subtractions: Schedule 511NR-B, line 15 ....................
22
C
22
Adjusted gross income: Okla. Source (line 21 minus line 22) .........
00
Name and Address
23
OR
23
00
Adjusted gross income: All Sources
(line 21 minus line 22) Also enter on line 25
24
24
Print or type the first name, middle initial and last name
• File as if both the resident and the nonresident
for both yourself and spouse, if applicable. Complete the
civilian were Oklahoma residents on Form 511. Use the
address portion including an apartment number and/or
“married filing joint” filing status, and report all income. A
rural route, if applicable.
tax credit (Oklahoma Form 511TX) may be used to claim
(continued on page 8)
7
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