Form Worksheets A - B Fillable Residency information and income allocation for nonresidents and part-year residents
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Safe Harbor residents for the first time Failure to enclose a completed Worksheet A with your 1040ME may delay processing of your return (NOTE: Married persons fi ling separate (Part year residents Nonresidents (See instructions at www maine gov/revenue/forms) Enclose with your Form 1040ME **If necessary use Worksheet C (Employee Apportionment Worksheet) for Part Year Residents/Nonresidents/ Safe *Part year residents must make an entry in Column C if income was earned in another jurisdiction during the 10 If you answered no to question 7(f) please explain the circumstances (Attach a separate sheet if necessary): 10 Rental real estate royalties 11 Farm income/loss 12 Unemployment Compensation 13 Taxable amount of social 14 Other income (including lump sum 15 Add lines 1 through 14 A for this period Alimony received and annuities and Safe Harbor residents) another state) (Enter date of move) 7 Attachment Attended or sent your children (if any) to a Maine school 8e Business income/loss c Occupation 1c Capital gain/loss Column A Column B Column C* Column D Column E Date of birth 1b Did you ever apply for a Homestead or Veterans property tax exemption? 5b distributions but excluding state During 2015: Unless otherwise indicated enter Yes or No on each line During period of nonresidency have you: earned outside of Maine Enclose with your Form 1040ME Enter new state of residence 7a Enter state of prior residence 6a Federal Income (Part year residents only) federal return A for this period for Part year Residents/Nonresidents/ Safe Harbor Residents from Maine sources Harbor Residents to calculate the amount for line 1 Column E For a copy of Worksheet C go to the Maine Revenue Have you disposed of the property? 5c I became a Maine resident on (Enter Date) 6 I moved from Maine and became a nonresident (I established a legal residence in I own(ed) a home/real property in Maine 5 I was domiciled in (Enter state(s)) 2 I was in the military and stationed in (Enter state or country) 3 If married did your spouse and dependent children (if any) move to your new If yes in what municipality was the property located? 5a If yes list employer (Yourself: Spouse: ) If yes when? (Yourself: Spouse: ) If yes when? (Yourself: Spouse: ) If yes when? (Yourself: Spouse: ) If yes when? (Yourself: Spouse: ) If yes when? (Yourself: Spouse: ) If you answered yes to question 5 but have not disposed of the property what use do Income Allocation Worksheet for Part Year Residents/Nonresidents/ Safe Harbor Residents Income from Column Income from Column B Income from Column D Income from Income from Column income tax refunds) line 1 of Schedule NR or Schedule NRH Listed Maine as your legal residence for any purpose 8g Maine income tax returns must complete Maine Resident Period My designated state of legal residence was (Enter state) 3a NAME 1 Name of other jurisdiction Period (mm/yy) From To Name of other jurisdiction Period (mm/yy) From To Name(s) as shown on Form 1040ME Nonresident Period nonresidents and Safe Harbor residents who are filing a Maine return for the first time and 3) former Maine residents who are filing as nonresidents or NOTE: See instructions at www maine gov/revenue/forms on how to use Worksheet B line 15 entries to complete NR or Schedule NRH Obtained a driver s license in Maine 6d Obtained a driver s license in my new state of residence 7d Obtained or renewed any Maine trade or professional licenses or union memberships 8h Ordinary dividends other compensation** Other gains/losses Part year residents Nonresidents and Safe Harbor residents must complete this worksheet before completing Schedule partnerships S corporations and Performed any work or services in Maine 8a period of Maine residency Enter below the name of each other jurisdiction and the dates the income was earned in Purchased a home in Maine 6c Purchased a home in my new state of residence 7c Purchased a Maine resident hunting or fi shing license 8f Registered an auto or other vehicle in Maine 6e Registered an auto or other vehicle in Maine 8b Registered an auto or other vehicle in my new state of residence 7e Registered to vote in Maine 6b Registered to vote in my new state of residence 7b Renewed a Maine driver s license 8c security benefi ts separate worksheets for each spouse) Sequence No 12 WORKSHEET A Residency Information Worksheet Sequence No 13 Services website at: www maine gov/revenue/forms or call (207) 624 7894 (to order) Social security number 1a state of residence? 7f Taxable amount of IRA distributions Taxable amount of pensions Taxable interest The following individuals must complete Worksheet A: 1) All part year residents whether moving into or out of Maine during the tax year; 2) The number of days I spent in Maine (for any purpose) was 4 those jurisdictions Use a separate sheet if additional space is needed trusts etc Voted in Maine in person or by absentee ballot 8d Wages salaries tips WORKSHEET B you intend to make of it and how often (Attach a separate sheet if necessary)? You must attach a copy of the income tax return(s) filed with the other jurisdiction Your Social Security Number Yourself Spouse