Form 1040N Fillable 2013 Nebraska Individual Income Tax Return  (12/10/2013
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

(1) Farmer/Rancher (2) Active Military (1) Deceased Taxpayer(s) (1) Resident (1) Single (2) Married filing jointly (2) Partial year resident from / 2013 to / 2013 (attach Schedule III) (3) Married filing separately Spouse s SSN: (4) Head of Household (5) Widow(er) with dependent children (attach a copy of Federal Form 2441 or Nebraska Form 2441N) 31 (attach Nebr Sch II and the other state's return) plus (Can be up to 17 characters Omit hyphens spaces and special symbols Enter from left to right and leave any unused boxes blank ) (Enter 9 digits first two digits must be 01 through 12 or 21 through 32; (first name & date of death): (the larger of line 6 or line 9) 10 10 Nebraska standard deduction or the Nebraska itemized deductions whichever is greater 11 Nebraska income before adjustments (line 5 minus line 10) 11 12 Adjustments increasing federal AGI (line 53 from attached Nebraska Schedule I) 12 13 Adjustments decreasing federal AGI (line 71 from attached Nebraska Schedule I) 13 14 Nebraska Taxable Income (enter line 11 plus line 12 minus line 13) If less than 0 enter 0 15 Nebraska income tax (Resident paper filers may use the Nebraska Tax Table 16 Nebraska minimum or other tax: 17 Total Nebraska tax before personal exemption credit (add lines 15 and 16) 19 Nebraska personal exemption credit for residents only ($126 per exemption) 19 20 a Credit for tax paid to another state Nebr Sch II line 76 20 a $ 2013 through 21 Credit for the elderly or disabled (attach copy of Federal Schedule R) 21 22 Community Development Assistance Act credit (see instructions) 22 23 Form 3800N nonrefundable credit (attach Form 3800N) 23 24 Nebraska child/dependent care nonrefundable credit only if line 5 is more 25 Credit for financial institution tax (see instructions) (attach Form NFC) 25 26 Total nonrefundable credits (add lines 19 through 25) 26 27 Subtract line 26 from line 18 (if line 26 is more than line 18 enter 0 ) If the result is greater than your 28 Nebr income tax withheld (attach 2013 Forms W 2 W 2G 1099 R 1099 MISC or K 1N) 28 29 2013 estimated tax payments (include any 2012 overpayment credited to 2013 and 3 Type of Return: 30 Form 3800N refundable credit (attach Form 3800N) 30 31 Nebraska child/dependent care refundable credit if line 5 is $29 000 or less 32 Beginning Farmer credit 32 33 Nebraska earned income credit Enter number of qualifying children 97 34 Angel Investment Tax Credit (see instructions) 34 35 Total refundable credits (add lines 28 through 34) 35 36 Penalty for underpayment of estimated tax (see instructions) If you calculated a Form 2210N penalty of 0 37 Total tax and penalty Add lines 27 and 36 37 38 Use tax due on Internet and out of state purchases See instructions 39 Total amount due If line 35 is less than total of lines 37 and 38 subtract line 35 from the total of lines 37 4 Federal exemptions (number of exemptions claimed on your 2013 federal return) 4 40 Overpayment If line 35 is more than total of lines 37 and 38 subtract total of lines 37 and 38 from line 35 40 41 Amount of line 40 you want applied to your 2014 estimated tax 41 42 Wildlife Conservation Fund donation of $1 or more 42 43 Amount of line 40 you want refunded to you (line 40 minus lines 41 and 42) 5 Federal adjusted gross income (AGI) (Federal Form 1040EZ line 4; Federal Form 1040A line 21; 6 Nebraska standard deduction (if you checked any boxes on line 2a or 2b above 7 Total itemized deductions (Federal Schedule A line 29 see instructions) 7 8 State and local income taxes (Federal Form 1040 line 5 Schedule A 9 Nebraska itemized deductions (line 7 minus line 8) 9 95 Local code (see local rate schedule); a Federal Alternative Minimum Tax (recalculated Form 6251) 16 a $ Add state and local taxes and enter on line 38 If no use tax is due enter 0 on line 38 38 All others must use Tax Calculation Schedule Partial year residents and and 38 Pay this amount in full For electronic or credit card payment check here and see instructions 39 and Full Name any payments submitted with an extension request) 29 b Federal Tax on Lump Sum Distributions (Form 4972) 16 b $ b Prior year AMT credit (attach Form 8801) 20 b $ c Federal tax on early distributions (lesser of Form 5329 or check box and attach a copy of the federal return 27 City State Zip Code Current Mailing Address (Number and Street or PO Box) d Total 16 d $ Do not pay the amount on this line Pay the amount from line 39 17 Enter purchases subject to local tax 93 $ Local tax 94 $ (purchases x local rate of %) Enter purchases subject to state tax 91 $ State tax 92 $ (purchases x 5 5%); Enter the total of lines 20a and 20b on line 20 20 Federal credit 98 $ 00 x 10 (10%) (attach federal return Federal Form 1040 line 37) 5 federal tax liability complete the Federal Tax Liability Worksheet in the instructions If entering federal tax File early! It may take three months to receive your refund if you file a paper return 43 If a Joint Return Spouse s First Name and Initial Last Name line 58 Form 1040) 16 c $ Mail returns not requesting a refund to: Nebraska Department of Revenue PO Box 98934 Lincoln NE 68509 8934 Mail returns requesting a refund to: Nebraska Department of Revenue PO Box 98912 Lincoln NE 68509 8912 Nebraska Schedule III 16 Nebraska Schedule III before continuing 14 nonresidents enter the result from line 85 Nebraska Schedule III) 15 on line 16 Partial year residents and nonresidents enter the result from line 86 or greater or used the annualized income method attach Form 2210N and check this box 96 36 pages 1 and 2 see instructions) 33 qualified widow[er]; $6 100 if married filing separately; or $8 950 if head of household) 6 Residents complete lines 15 and 16 Partial year residents and nonresidents complete Residents multiply line 16d by 29 6% ( 296) and enter the result see instructions ) 8 see instructions; otherwise enter $6 100 if single; $12 200 if married filing jointly or Spouse s Signature (if filing jointly both must sign) Daytime Phone than $29 000 (attach a copy of Federal Form 2441 and see instructions) 24 use an actual check or savings account number not a deposit slip) Your First Name and Initial Last Name Your Social Security Number Spouse s Social Security Number (3) Nonresident (attach Schedule III) 18 Amount from line 17 (Total Nebraska tax) 18 44a Routing Number 44b Type of Account 1 = Checking 2 = Savings 44c Account Number 44d Check this box if this refund will go to a bank account outside the United States 8 417 2013 Check here if someone (such as your parent) can claim you or Check if YOU were: (1) 65 or older (2) Blind Complete Reverse Side Expecting a Refund? Have it sent directly to your bank account! (see instructions) Federal Filing Status: for the taxable year January 1 2013 through December 31 2013 or other taxable year: FORM 1040N High School District Code Important: SSN(s) must be entered below Keep a copy of Nebraska Individual Income Tax Return Please PLEASE DO NOT WRITE IN THIS SPACE preparer s Preparer s Signature Date Preparer s PTIN Print Firm s Name (or yours if self employed) Address and Zip Code EIN Daytime Phone SPOUSE was: (3) 65 or older (4) Blind this return for Type or Print Under penalties of perjury I declare that as taxpayer or preparer I have examined this return and to the best of my knowledge and belief it is correct and complete use only your records Your Signature Date Email Address your spouse as a dependent: (1) You (2) Spouse