Form 1040me - Maine Individual Income Tax - 2012
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1
2
32012
MAINE INDIVIDUAL INCOME TAX
FORM 1040ME
99
For tax period
2 0 1 2
to
*1202100*
1/1/2012 to 12/31/2012 or
See instructions on pages 2 and 3. Print neatly in blue or black ink only.
IMPORTANT!
You must enter your SSN(s) below.
Your First Name
MI
Your Last Name
Your Social Security Number
Spouse’s First Name
MI
Spouse’s Social Security Number
Spouse’s Last Name
Home Phone Number
Mailing Address (PO Box, number, street and apt. no)
Work Phone Number
City
State
ZIP Code
NOTE: If either spouse is deceased, enter the date of death on Form 1040ME, page 3 in the spaces provided above the signature area.
1
Maine Clean Election Fund. Maine Residents Only.
2 Check here if you were engaged in COMMERCIAL
Check here if you, or your spouse, if fi ling jointly,
FARMING OR FISHING during 2012 .....................
You
Spouse
want $3 to go to this fund.
FILING STATUS (Check one)
RESIDENCY STATUS (Check one)
12 CHECK IF:
You
Spouse
were
was
3
Single
8
Resident
4
Married fi ling joint return (Even if only one had income)
65 or over ........ 12a
12c
8a
“Safe Harbor” Resident
5
Married fi ling separate return. Enter spouse’s social
Blind................. 12b
12d
security number and full name above.
9
Part-Year Resident
6
Head of household (With qualifying person)
10
Nonresident
13 Enter the TOTAL number of
7
Qualifying widow(er) with dependent child
EXEMPTIONS claimed
on your federal return ....13
11
Nonresident Alien
(
Year spouse died
)
Check here if you are
fi ling Schedule NRH
Composite Return (Pass-through Entities ONLY)
.00
14
FEDERAL ADJUSTED GROSS INCOME. ............................................................... 14
.00
15
INCOME MODIFICATIONS. (From Schedule 1, line 3.) .......................................... 15
.00
16
MAINE ADJUSTED GROSS INCOME. (Line 14 plus or minus line 15). ................. 16
.00
17
DEDUCTION.
Standard (See instructions on page 2) ............................... 17
Itemized (From Maine Schedule 2, line 7.)
.00
18
EXEMPTION. Multiply the number of exemptions on line 13 by $2,850. (See instructions.) .............. 18
.00
19
TAXABLE INCOME. (Line 16 minus lines 17 and 18.) ........................................... 19
20
INCOME TAX. (Find the tax for the amount on line 19 in the tax table
on pages 19-20 or compute your tax using the tax rate
.00
schedules at ) .......................................................... 20
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