Form 511x - Oklahoma Amended Resident Individual Income Tax Return - 2012 Page 2
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Form 511X - 2012
Oklahoma Amended Resident
Individual Income Tax Return
Part-year and nonresidents must use Form 511NR to amend.
Tax Year 2012
Your Social Security Number
Check box if
this taxpayer
If a Joint Return, Spouse’s
is deceased
Social Security Number
Your first name, middle initial and last name
If a joint return, spouse’s first name, middle initial and last name
Did you file an amended Federal return?
Present home address (number and street, including apartment number or rural route)
Yes
No
Enclose a copy of IRS Form 1040X or 1045 AND a copy of the “Statement of
Adjustment”, IRS check, or deposit slip. IRS documents submitted after filing
City, State and Zip
Form 511X may delay the processing of your return.
•
Filing status claimed: (Note: Generally, your filing status must be the same as on your Federal return. See Form 511 instructions.)
On original return:
1. Single
2. Married filing joint
3. Married filing separate
4. Head of Household
5. Qualifying widow(er)
On this return:
1. Single
2. Married filing joint
3. Married filing separate
4. Head of Household
5. Qualifying widow(er)
•
Number of Exemptions:
Not Required to File...
Regular
Special
Blind
Dependents
Total
On original return:
+
+
+
=
Check this box if you do not
have sufficient gross income
On this return:
+
+
+
=
to require you to file a Federal Return.
•
Check if you or your spouse are 65 or over:
Yourself
Spouse
A:
B:
C:
Income and Deductions...
As Originally
Office Use Only
Amended
Reported or as
Previously Adjusted
1
Federal adjusted gross income ...................................
00
1
00
00
00
00
00
2
Oklahoma subtractions (enclose Schedule 511X-A) ...
2
00
00
00
3
3
Subtract line 2 from line 1 ............................................
00
4
00
00
4
Out-of-state income (see instructions).........................
00
5
00
00
5
Subtract line 4 from line 3 ............................................
00
6
00
00
6
Oklahoma additions (enclose Schedule 511X-B) ........
00
00
00
7
7
Oklahoma adjusted gross income (add lines 5 and 6)
Adjustments to Oklahoma adjusted gross income
8
(enclose Schedule 511X-C) .........................................
00
00
00
8
9
Subtract line 8 from line 7 ............................................
00
00
00
9
10
Deductions plus exemptions .......................................
00
10
00
00
11
Percentage allowable (divide line 7 by line 3)
(not to exceed 100 percent) ........................................
%
11
%
%
12
Multiply line 10 by line 11 ............................................
00
12
00
00
Oklahoma taxable income
13
subtract line 12 from 9 ................................................
00
13
00
00
Tax Liability...
14
Income Tax from Tax Table (see instructions) . . . . . .
If using Farm Income Averaging, enter tax from Form 573 and
enter a “1” in the box. If paying Health Savings Account additional
10% tax, add additional tax here and enter a “2” in the box . . . . .
00
14
00
00
15
A. Oklahoma child care credit . . . . . . . . . . . . . . . . . . .
00
A
00
00
B. Credit for taxes paid to another state
00
B
00
00
(enclose 511TX)
C. Other credits. List Form 511CR line number here
00
C
00
00
D. Subtotal: Income tax (line 14 minus lines 15A-C) .
00
D
00
00
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