Form 1-Nr/py - Mass. Nonresident/part-Year Resident Tax Return - 2012 Page 2
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6SOCIAL SECURITY NUMBER
2012 FORM 1-NR/PY
PAGE 2
0 0
0 0
0 0
7
–
–
=
a. 3
b. 3
. . . . . . . . . . . . . . . a
b
7
Massachusetts bank interest
Exemption amount
Exemption: if married filing jointly, subtract $200 from line 7a; otherwise subtract $100 and enter result (not less than “0”).
If showing a loss, mark an X in box at left
5
8
Business/profession or farm income/loss (enclose Massachusetts Schedule C or U.S.
0 0
Schedule F). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8
9
If you are reporting rental, royalty, REMIC, partnership, S corporation, trust income/loss,
0 0
see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9
0 0
10
a. Unemployment compensation. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 10a
0 0
b. Massachusetts state lottery winnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 10b
11
Other income (alimony, taxable IRA/Keogh distribution, winnings, fees) from Schedule X,
0 0
line 5 (enclose Schedule X; not less than “0”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 11
0 0
12
TOTAL 5.25% INCOME. Add lines 5 through 11. (Be sure to subtract any loss(es) in lines 8 or 9) 12
13
NONRESIDENT APPORTIONMENT WORKSHEET. You cannot apportion Massachusetts wages as shown on Form W-2. Do not use this work-
sheet if you know the exact amount of your Massachusetts source income. Use only when income from employment/business is earned both
inside and outside Massachusetts and the exact Massachusetts amount is not known.
Basis:
working days
miles
sales
other:
0 0
a. Working days (or other basis) outside Massachusetts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13a
0 0
b. Working days (or other basis) inside Massachusetts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13b
0 0
c. Total working days. Add line 13a and line 13b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13c
0 0
d. Nonworking days (holidays, weekends, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13d
e. Massachusetts ratio. Divide line 13b by line 13c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13e
0 0
f. Total income being apportioned (you cannot apportion Mass. wages as shown on Form W-2) . . . 13f
g. Massachusetts income. Multiply line 13e by line 13f. Enter here and in appropriate lines on
0 0
pages 1 and 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13g
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NONRESIDENT DEDUCTION & EXEMPTION RATIO. Nonresident taxpayers must complete this item to determine the ratio for apportioning
the deductions in lines 16 and 17; certain Schedule Y deductions (see instructions); the exemptions in line 22a; and the EIC in line 45.
0 0
a. Total 5.25% income (from line 12). Not less than “0” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14a
0 0
b. Interest income (smaller of line 7a or line 7b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14b
c. Total capital gain income, if any (total of Schedule B, Part 1, line 7; Schedule B, Part 2, line 13;
0 0
Schedule D, line 13. Not less than “0.”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14c
0 0
d. Total income this return. Add lines 14a, b and c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14d
0 0
e. Non-Massachusetts source income. Not less than “0.” See instructions. . . . . . . . . . . . . . . . . . 3 14e
0 0
f. Total income. Add line 14d and line 14e. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14f
g. Deduction and exemption ratio. Divide line 14d by line 14f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14g
DEDUCTIONS. Amounts entered in line(s) 15a and/or 15b must be related to Massachusetts income reported on this return.
15
a. Amount you paid to Social Security, Medicare, Railroad, U.S. or Mass. retirement. Not more than $2,000.
0 0
(Medicare premiums deducted from your Soc. Sec. or retirement payments are not deductible.). . . . . . . . . . . . . 3 15a
b. Amount your spouse paid to Social Security, Medicare, Railroad, U.S. or Mass. retirement. Not more than
0 0
$2,000. (Medicare premiums deducted from your Soc. Sec. or retirement payments are not deductible.) . . . . . . 3 15b
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