Form 511x - Oklahoma Amended Resident Individual Income Tax Return - 2012 Page 4

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2012 Form 511X - Page 3 - Amended Resident Income Tax Return
NOTE: Enclose this page ONLY if you have an amount shown on a schedule.
Name(s) shown
Your Social
on Form 511X:
Security Number:
Oklahoma Subtractions
Schedule 511X-A
See instructions in 511 Packet for details
on qualifications and required enclosures.
B: Amended
00
1
Interest on U.S. government obligations ........................................................................
1
Social Security benefits taxed on your Federal Form 1040 or 1040A ............................
2
00
2
00
3
Federal civil service retirement in lieu of social security .................................................
3
Retirement Claim Number: Taxpayer
Spouse
00
4
Military Retirement
..............................................................
(see 511 Packet for limitation)
4
00
5
Oklahoma government or Federal civil service retirement
......
(see 511 Packet for limitation)
5
00
6
Other retirement income .................................................................................................
6
U.S. Railroad Retirement Board benefits .......................................................................
00
7
7
00
8
Oklahoma depletion........................................................................................................
8
00
9
Oklahoma net operating loss ..........................................................................................
9
00
10
Exempt tribal income .....................................................................................................
10
00
11
Gains from the sale of exempt government obligations ................................................
11
00
12
Oklahoma Capital Gain Deduction (enclose Form 561) ................................................
12
00
13
Miscellaneous: Other subtractions (enter number in box for type of deduction)
13
Total subtractions
00
14
..
(add lines 1-13, enter total here and on Form 511X, Line 2, Column B)
14
Oklahoma Additions
Schedule 511X-B
See instructions in 511 Packet for details
on qualifications and required enclosures.
B: Amended
1
State and municipal bond interest ...............................................................................
00
1
2
Out-of-state losses (describe: __________________________ )
00
2
Enter as a positive number .
3
Lump sum distributions (not included in your Federal Adjusted Gross Income) ........
00
3
4
Federal net operating loss -
..........................................................
00
4
Enter as a positive number
5
00
Recapture of depletion claimed on a lease bonus or add back of excess Federal depletion
5
6
Expenses incurred to provide child care programs .....................................................
00
6
7
00
Recapture of contributions to Oklahoma 529 College Savings Plan and OklahomaDream 529 Account(s) .
7
8
Miscellaneous: Other additions (enter number in box for type of addition) .......
00
8
Total additions
9
........
00
(add lines 1-8, enter total here and on Form 511X, Line 6, Column B)
9
Oklahoma Adjustments
Schedule 511X-C
See instructions in 511 Packet for details
on qualifications and required enclosures.
B: Amended
1
Military pay exclusion - Active duty, Reserve and National Guard
...
00
(not retirement income)
1
Qualifying disability deduction ........................................................................................
2
00
2
3
00
Political contributions (limited to $100 [$200 for joint return]) .........................................
3
4
00
Interest qualifying for exclusion (limited to $100 [$200 for joint return]) ........................
4
Qualified adoption expense ............................................................................................
5
00
5
00
6
Contributions to Oklahoma 529 College Savings Plan and OklahomaDream 529 Account(s) ..6
7
Miscellaneous: Other adjustments (enter number in box for type of deduction)
00
7
Total adjustments
8
......
00
(add lines 1-7, enter total here and on Form 511X, Line 8, Column B)
8

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