Form 40 Idaho Individual Income Tax

11 TOTAL ADJUSTED INCOME Subtract line 10 from line 9 7 Enter your federal adjusted gross income from federal Form 1040 line 37; federal Form 1040A line 21; 8 Additions from Form 39R Part A line 7 Include Form 39R 8 9 Total Add lines 7 and 8 9 Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account Enter the total number here c federal Schedule A line 5 14 if different than the Standard Deduction For Most People 16 in 2012 or federal Form 1040EZ line 4 Include a complete copy of your federal return 7 Routing No To donate your grocery credit to the Cooperative Welfare Fund check the box and enter zero on line 42 To receive your grocery credit enter the computed amount on line 42 42 Yes No $11 900 $5 950 $8 700 {"6S } {"6U } 00 00 00 07 20 12 1 Single 10 Subtractions from Form 39R Part B line 23 Include Form 39R 10 13 Itemized deductions Include federal Schedule A 13 14 All state and local income taxes included on 15 Subtract line 14 from line 13 If you do not use federal Schedule A enter zero 15 16 Standard deduction See instructions page 7 to determine standard deduction amount 17 Subtract the LARGER of line 15 or 16 from line 11 If less than zero enter zero 17 18 Multiply $3 800 by the number of exemptions claimed on line 6d 18 19 Idaho taxable income Subtract line 18 from line 17 If less than zero enter zero 19 2 Married filing joint return 3 Married filing separate return 4 Head of household 5 Qualifying widow(er) 20 Tax from tables or rate schedule See instructions page 36 20 21 Tax amount from line 20 21 22 Income tax paid to other states Include Form 39R and a copy of other state return 22 23 Total credits from Form 39R Part E line 4 Include Form 39R 23 24 Total business income tax credits from Form 44 Part I line 12 Include Form 44 24 25 TOTAL CREDITS Add lines 22 through 24 25 26 Subtract line 25 from line 21 If line 25 is more than line 21 enter zero 26 27 Fuels tax due Include Form 75 27 28 Sales/Use tax due on Internet mail order and other nontaxed purchases 28 29 Total tax from recapture of income tax credits from Form 44 Part II line 7 Include Form 44 29 30 Tax from recapture of qualified investment exemption (QIE) Include Form 49ER 30 31 Permanent building fund Check the box if you are receiving Idaho public assistance payments 31 32 TOTAL TAX Add lines 26 through 31 32 33 Nongame Wildlife Conservation Fund 34 Idaho Children's Trust Fund 35 Special Olympics Idaho 36 Idaho Guard and Reserve Family 37 American Red Cross of Greater Idaho Fund 38 Veterans Support Fund 39 Idaho Foodbank 40 Opportunity Scholarship Program 41 TOTAL TAX PLUS DONATIONS Add lines 32 through 40 41 42 Grocery credit Computed Amount (from worksheet) 43 Maintaining a home for family member age 65 or older or developmentally disabled Include Form 39R 43 44 Special fuels tax refund Gasoline tax refund Include Form 75 44 45 Idaho income tax withheld Include Form(s) W 2 and any 1099(s) that show Idaho withholding 45 46 2012 Form 51 payment(s) and amount applied from 2011 return 46 47 Pass through income tax Withheld Paid by entity Include Form(s) ID K 1 47 48 Hire One Act credit for new employees Include Form 72 48 49 TOTAL PAYMENTS AND OTHER CREDITS Add lines 42 through 48 49 50 TAX DUE Subtract line 49 from line 41 51 Penalty Interest from the due date Enter total 51 52 TOTAL DUE Add lines 50 and 51 Make check or money order payable to the Idaho State Tax Commission 52 53 OVERPAID Line 49 minus lines 41 and 51 This is the amount you overpaid 53 54 REFUND Amount of line 53 to be refunded to you 55 ESTIMATED TAX Amount of line 53 to be applied to your 2013 estimated tax 55 56 DIRECT DEPOSIT See instructions page 11 Check if final deposit destination is outside the U S 57 Total due (line 52) or overpaid (line 53) on this return 57 58 Refund from original return plus additional refunds 58 59 Tax paid with original return plus additional tax paid 59 6 EXEMPTIONS 60 Amended tax due or refund Add lines 57 and 58 and subtract line 59 60 Account No Account: Address and phone number AMENDED RETURN check the box AMENDED RETURN ONLY Complete this section to determine your tax due or refund See instructions and 6b if they apply c List your dependents If more than four dependents continue on Form 39R CHECK check here and enter zero on lines 18 and 42 Checking City State and Zip Code Continue to page 2 CREDITS Limits apply See instructions page 8 d Total exemptions Add lines 6a through 6c Must match federal return d Daytime phone Deduction Do you need Idaho DONATIONS See instructions page 8 I want to donate to: EFO00089 EFO00089p2 07 20 12 Enter "1" in boxes 6a FILING STATUS Check only one box First name Last name Social Security Number For calendar year 2012 or fiscal year beginning ending For Most Form 40 2012 Head of Household: IDAHO INDIVIDUAL INCOME TAX RETURN If age 65 or older If blind If filing married joint or separate return enter spouse's name and Social Security Number above If someone can claim you as a dependent leave box 6a blank If you have an NOL and are electing to forgo the carryback period check here 11 If your parent or someone else can claim you as a dependent INCLUDE A COMPLETE COPY OF YOUR FEDERAL RETURN INCOME See instructions page 7 income tax forms Jointly or Qualifying Widow(er): Last name MAIL TO: Idaho State Tax Commission PO Box 56 Boise ID 83756 0056 mailed to you next year? Mailing address Married filing Must match federal return OTHER TAXES See instructions page 8 Page 2 Paid preparer's signature PAYMENTS and OTHER CREDITS Complete the grocery credit refund worksheet on page 9 People PLEASE PRINT OR TYPE Preparer's EIN SSN or PTIN Savings See instructions page 6 for the reasons for amending and enter the number Single or Married filing Separately: Spouse Spouse b Spouse deceased Spouse's first name and initial Spouse's signature (if a joint return BOTH MUST SIGN) Spouse's Social Security Number (required) Standard State Use Only TAX COMPUTATION See instructions page 7 TAX DUE or REFUND See instructions page 10 If line 41 is more than line 49 GO TO LINE 50 If line 41 is less than line 49 GO TO LINE 53 Taxpayer deceased Type of Under penalties of perjury I declare that to the best of my knowledge and belief this return is true correct and complete See instructions Within 180 days of receiving this return the Idaho State Tax Commission may discuss this return with the paid preparer identified below Your first name and initial Your signature Your Social Security Number (required) Yourself Yourself a