Form 740 - Kentucky Individual Income Tax Return - 2004 Page 2
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1
2FORM 740 (2004)
Page 2
Dollars
Cents
TAX
0
0
.
18 Enter amount from line 17 ..................................................................................................................... 18
0
0
.
__ . __ __
__ __ __
19 Multiply line 18 by the low income tax credit decimal amount
(
%) and enter here 19
0
0
.
20 Subtract line 19 from line 18 ................................................................................................................. 20
21 Enter Child and Dependent Care Credit
0
0
.
from federal Form 2441, line 9
x 20% (.20) ..................... 21
0
0
.
22 Income Tax Liability. Subtract line 21 from line 20. If line 21 exceeds line 20, enter zero ............ 22
0
0
.
23 Enter KENTUCKY USE TAX from worksheet in the instructions ....................................................
23
0
0
.
24 Add lines 22 and 23. This is your Total Tax Liability .......................................................................... 24
25 (a) Enter Kentucky income tax withheld
0
0
as shown on attached 2004 Form W-2,
.
Wage and Tax Statement(s) ........................... 25(a)
0
0
(b) Enter 2004 Kentucky estimated tax
.
payments ......................................................... 25(b)
0
0
.
26 Add lines 25(a) and 25(b) ....................................................................................................................... 26
0
0
.
27 If line 26 is larger than line 24, enter AMOUNT OVERPAID (see instructions) ................................ 27
See instructions for a detailed description of funds.
(Enter amount(s) checked)
28 Nature and Wildlife Fund Contribution
0 0
.
$2
$5
$10
Other
........... 28
0
0
29 Child Victims' Trust Fund Contribution
.
$2
$4
Other
................................ 29
0
0
30 Bluegrass State Games and U.S. Olympic Committee
.
Fund Contribution .......................................................................... 30
0
0
.
31 Veterans' Program Trust Fund Contribution ............................... 31
0
0
.
32 Add lines 28 through 31 ......................................................................................................................... 32
0
0
.
ESTIMATED TAX
33 Amount of line 27 to be CREDITED to your 2005 estimated tax ...........
33
0
0
.
REFUND
34 Subtract lines 32 and 33 from line 27. Amount to be REFUNDED TO YOU ...........
34
TAX PAYMENT SUMMARY
0
0
.
35 If line 24 is larger than line 26, enter ADDITIONAL TAX DUE ............................................................ 35
36 (a) 2210-K
(c)
Late payment
penalty
penalty
(d) Late filing
Check if Form 2210-K attached
penalty
(e) Add lines 36(a) through 36(d).
0
0
.
(b) Interest
Enter here .............................................. 36(e)
0
0
.
37 Add lines 35 and 36(e) and enter here. This is the AMOUNT YOU OWE .....................
OWE
37
Make check payable to Kentucky State Treasurer.
Write your Social Security number and "KY Income Tax—2004" on the check.
Staple check on top of attached wage and tax statements on page 1.
Attach a complete copy of federal Form 1040 if you received
Yes
No
farm, business, or rental income or loss.
If you are not required to attach a copy of your federal return,
Do you wish to receive a packet next
1
2
c
heck here ..................................................................................
year? (check one) ..........................
I, the undersigned, declare under penalties of perjury that I have examined this return, including all accompanying schedules and statements, and to the best
of my knowledge and belief, it is true, correct and complete. I also understand and agree that our election to file a combined return under the provisions of
Regulation 103 KAR 17:020 will result in refunds being made payable to us jointly and in each of us being jointly and severally liable for all taxes accruing
under this return.
Your Signature (If joint or combined return, both must sign.)
Spouse's Signature
Date Signed
Telephone Number (daytime)
Typed or Printed Name of Preparer Other than Taxpayer
I.D. Number of Preparer
Date
Mail to:
REFUNDS
Kentucky Department of Revenue, Frankfort, KY 40618-0006.
Official Use Only
EST CF
NT
P B F R
PAYMENTS
Kentucky Department of Revenue, Frankfort, KY 40619-0008.
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