Fillable Form 1x - Amended Return Wisconsin Income Tax

Form 1x - Amended Return Wisconsin Income Tax - 2013 Page 3

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2013 Form 1X – Amended Return

(continued)

3 of 4

Page

Name(s) shown on Form 1X

Your social security number

40 Fill in amount from line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

.00

41 Fill in amount from line 39 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

42 If line 40 is less than line 41, subtract line 40 from line 41 . . . . . . . This is the AMOUNT OVERPAID 42

.00

43 Amount of line 42 you want REFUNDED TO YOU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

.00

44 Amount to be applied to your 2014 estimated tax (see instructions) . . . 44

45 If line 40 plus line 44 is more than line 41, subtract line 41 from

the sum of lines 40 and 44 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . ADDITIONAL TAX 45

.00

46 Interest charge (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

47 TOTAL AMOUNT DUE – Pay in full with this return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

.00

) Exception Code  . .

.00

48 Underpayment interest (

see instructions

Explanation of Changes to Income, Payments, and Credits

Explanation

Codes (see instructions)

Indicate the line reference(s) from pages 1 and 2 for which you are reporting a change and explain in detail the reason for the change.

Fill in the name used on your 2013 return

(if same as name filled in on page 1, write “Same”)

Sign here

Under penalties of law, I declare that this amended return and all attachments are true, correct, and complete to the best of my knowledge and belief.

Your signature

Spouse’s signature (if filing jointly, BOTH must sign)

Date

Daytime phone

(

)

For Department Use Only

Mail your Form 1X

(and make check payable) to:

Wisconsin Department of Revenue

PO Box 8991

Madison WI 53708‑8991