00 no exception available
Spouse s
Yours
1 2011 tax liability See instructions
10 Exception 1 See worksheet on page 3 If you meet this exception you do not owe an underpayment penalty STOP You do not need to file this form
11 Exception 2 Prior Year s Tax Liability
12 Exception 3 Prior Year s Income
13 Exception 4 Annualized Income
14 Exception 5 Installment Period Income
15 Amount of underpayment (from Line 9 above)
16 Date of Payment See instructions
17 Number of days from due date of installment
18 Penalty See instructions
19 Penalty Add amounts on Line 18 Print the total here and on Form IT 540B NRA Line 17 if you have an overpayment Print the total here and on Form IT 540B NRA Line 43 if you have a balance due
2 2010 tax liability See instructions
3 Enter the smaller of Line 1 or Line 2
4 Number of payments required for year
5 Required payment From Section 1 divide amount on Line 3 by the amount on Line 4 See instructions
6 Amount paid for each period See instructions
7 Carryforward Overpayment or underpayment from previous period on Line 9 of each column Carryforward amounts from the previous period can be a positive number or a negative number Note: No carryforward amount can be shown for the first period See instructions
8 Amount available for period Add Lines 6 and 7
9 Underpayment or overpayment Subtract Line 5 from Line 8 A positive number indicates an overpayment A negative number indicates an underpayment Move the number on this line to Line 7 in next column
Name shown on tax return Social Security Number
Section 1 Required Annual Payment
Section 2 Underpayment Computation 04/15/11 06/15/11 09/15/11 01/15/12
Section 3 Exceptions
Section 4 Penalty Computation
Spouse s
Yours