Form It-540 Web - Louisiana Resident - 2014 Page 3
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11IT-540 WEB
(Page 3 of 4)
Enter your Social Security Number.
2014 LOUISIANA REFUNDABLE CHILD CARE CREDIT – Your Federal Adjusted Gross Income must
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be EQUAL TO OR LESS THAN $25,000 to claim the credit on this line. See instructions, page 31, and
Refundable Child Care Credit Worksheet.
19A
19A Enter the qualifi ed expense amount from the Refundable Child Care Credit Worksheet, Line 3.
19B
19B Enter the amount from the Refundable Child Care Credit Worksheet, Line 6.
2014 LOUISIANA REFUNDABLE SCHOOL READINESS CREDIT – Your Federal Adjusted Gross Income
must be EQUAL TO OR LESS THAN $25,000 to claim the credit on this line. See Refundable School
Readiness Credit Worksheet.
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EARNED INCOME CREDIT – See Louisiana Earned Income Credit (LA EIC) Worksheet, Line 3.
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LOUISIANA CITIZENS INSURANCE CREDIT
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OTHER REFUNDABLE TAX CREDITS – From Schedule F, Line 7
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AMOUNT OF LOUISIANA TAX WITHHELD FOR 2014 – Attach Forms W-2 and 1099.
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AMOUNT OF CREDIT CARRIED FORWARD FROM 2013
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AMOUNT OF ESTIMATED PAYMENTS MADE FOR 2014
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AMOUNT PAID WITH EXTENSION REQUEST
TOTAL REFUNDABLE TAX CREDITS AND PAYMENTS – Add Lines 19, and 20 through 27. Do not include
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amounts on Lines 19A and 19B.
OVERPAYMENT – If Line 28 is greater than Line 18, subtract Line 18 from Line 28. Your overpayment may be
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reduced by the Underpayment of Estimated Tax Penalty. Otherwise, go to Line 36.
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UNDERPAYMENT PENALTY – See instructions for Underpayment Penalty, page 37 and Form R-210R.
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If you are a farmer, check the box.
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ADJUSTED OVERPAYMENT – If Line 29 is greater than Line 30, subtract Line 30 from Line 29. If Line 30 is greater
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than Line 29, subtract Line 29 from Line 30, and enter the balance on Line 36.
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TOTAL DONATIONS – From Schedule D, Line 26
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SUBTOTAL – Subtract Line 32 from Line 31. This amount of overpayment is available for credit or refund.
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CREDIT
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AMOUNT OF LINE 33 TO BE CREDITED TO 2015 INCOME TAX
AMOUNT TO BE REFUNDED – Subtract Line 34 from Line 33. If mailing to LDR, use Address 2 on the next page.
Enter a “1” in box if you want to receive your refund on a MyRefund card.
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REFUND
Enter a “2” in box if you want to receive your refund by paper check.
Enter a “3” in box if you want to receive your refund by direct deposit. Complete
information below. If information is unreadable, or if you do not make a refund
selection, you will receive your refund by paper check.
DIRECT DEPOSIT INFORMATION
Will this refund be forwarded to a fi nancial
institution located outside the United States?
Yes
No
Type:
Checking
Savings
Routing
Account
Number
Number
WEB
COMPLETE AND SIGN RETURN ON NEXT PAGE.
Enter the fi rst 4 characters of your
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last name in these boxes.
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