Form 740 - Kentucky Individual Income Tax Return - 2004
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740
ENTUCKY
NDIVIDUAL
NCOME
AX
ETURN
Full-Year Residents Only
42A740
For calendar year or
2004
Department of Revenue
other taxable year beginning _________ , 2004, and ending ________ , 200___ .
A.
B.
Spouse’s Social Security Number
Your Social Security Number
A.
B.
Spouse’s
Yours
Name—Last, First, Middle Initial (Joint or combined return, give both names and initials.)
L
Mailing Address (Number and Street or P.O. Box)
Apartment Number
A
B
E
City, Town or Post Office
State
ZIP Code
L
FILING STATUS (see instructions)
POLITICAL PARTY FUND
Designating $2 will not change your refund or tax due.
1
Single
A. Spouse
B. Yourself
2
Married , filing separately on this combined return. (If both had income.)
Democratic
(1)
(4)
Married , filing joint return.
3
Republican
(2)
(5)
Married , filing separate returns. Enter spouse's Social Security number above
4
No Designation
(3)
(6)
and full name here.
Check Regular
Check both if 65 or over
Check both if blind
CREDITS
5 (a) Credits for yourself:
5 Enter number of
boxes checked
(b) Credits for spouse:
6 List first names of your dependent children who lived with you.
6 Enter number of
(a)
(b)
(c)
(d)
children listed
7 List name and relationship of other dependents.
7 Enter number of other
dependents listed
8 Add total number of credits claimed on lines 5, 6 and 7. If married filing separately on a combined
8 Enter total credits
return (Filing Status 2), divide the amount on line 8 and enter in Boxes A and B. All other filers enter
the amount from line 8 in Box B ...............................................................................................................
A.
B.
Each taxpayer must claim his or her own credits from line 5. Credits from lines 6 and 7 may be divided.
A.
B.
Spouse (Use if Filing Status 2 is checked.)
Yourself (or Joint)
ADJUSTED GROSS INCOME
Dollars
Cents
Dollars
Cents
9 Enter amount from federal Form 1040,
0
0
0
0
.
.
line 36; 1040A, line 21 or 1040EZ, line 4 .........
9
0
0
0
0
.
.
10 Additions from Schedule M, line 7 ................. 10
0
0
0
0
.
.
11 Add lines 9 and 10 ............................................ 11
0
0
0
0
.
.
12 Subtractions from Schedule M, line 17 .......... 12
0
0
0
0
13 Subtract line 12 from line 11. This is your
.
.
Kentucky Adjusted Gross Income .................... 13
(If total of Columns A and B is $25,000 or less,
see Low Income Credit in instructions.)
TAXABLE INCOME
14 Itemizers: Enter itemized deductions from
0
0
0
0
Kentucky Schedule A. Nonitemizers: Enter
.
.
$1,870 in Columns A and/or B ............................. 14
0
0
0
0
15 Subtract line 14 from line 13. This is
.
.
your Taxable Income ........................................ 15
TAX
16 Enter tax from Tax Table or Computation.
0
0
0
0
.
.
Check if from Schedule TC
.................... 16
0
0
.
17 Add tax amount(s) in Columns A and B, line 16 .................................................................................. 17
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