Form Ia 1040x - Amended Iowa Individual Income Tax Return - 2015 Page 2
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4Explanation of Changes to Income, Deductions, and Credits
Enter the line reference from page 1 for which you are reporting a change and give the reason for each change.
Enclose a copy of any supporting schedules, worksheets, and documentation to substantiate the changes.
Please indicate how the changes in income, deductions, or credits are allocated between spouses.
Explanation of Social Security and Pension Exclusion changes
For 1997-2013, enter the corrected amount from line 13 of the Social Security Worksheet.
Spouse:
You:
For 2014 and later, enter the reportable amount from line 11 of the Social Security Worksheet.
Spouse:
You:
Please indicate any changes to Pension/Retirement income exclusion from IA 1040, line 21.
Spouse:
You:
Credit Carryforward
If you are amending prior to the end of the year for which this return came due and wish to change your credit carryforward (estimated tax),
please fill in these line items.
Calculated Overpayment ........................................................... 1.
Elected Carryforward amount for
You .................... A.
Spouse .............. B.
Total Carryforward. Add lines A and B ....................................... 2.
Subtract line 2 from line 1 and enter on IA 1040X, Line 28 ........ 3.
DO YOU OWE ADDITIONAL TAX?
FINAL CHECKLIST
You have several options:
Before you mail this return, make sure you:
1.
Payment transfer from your bank account: Go to
Check your math!
https://tax.iowa.gov/ and make an ePayment (direct debit)
Provide an explanation of the change.
through eFile & Pay.
Compute interest and any applicable penalty on additional
2.
Pay by credit/debit card online: Go to this web page:
tax due.
https://tax.iowa.gov/. Please note that you will be
Sign your return.
charged a service fee by the vendor.
Verify your Social Security Number(s).
3.
Mail your payment made payable to Treasurer, State of
Make your payment, if required.
Iowa with voucher IA 1040XV to Iowa Department of
Mail return to:
Revenue, Iowa Income Tax Processing, PO Box 9187,
Iowa Income Tax Processing Iowa Department of Revenue
Des Moines IA 50306-9187.
PO Box 9187
4.
Please do not send cash by mail.
Des Moines IA 50306-9187
NOTE: State tax information may be disclosed to tax officials of
OR File electronically for a faster refund
another state or of the United States for tax administrative
purposes.
Questions? Please contact Taxpayer Services at 515-281-
3114 or 1-800-367-3388 (Iowa, Omaha, Rock Island, Moline).
E-mail: idr@iowa.gov.
*1441122029999*
41-122b (10/12/15)
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