Page 2 — 2012 Form 40P |
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40 |
Amount from front of form, line 38F (federal amount) |
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40 |
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.00 |
DEDUCTIONS |
41 |
Itemized deductions from federal Schedule A, line 29 |
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• 41 |
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.00 |
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AND |
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• 42 |
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42 |
State income tax claimed as itemized deduction |
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.00 |
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MODIFICATIONS |
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EITHER, |
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...................................... |
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• 43 |
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43 |
Net Oregon itemized deductions. Line 41 minus line 42 |
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.00 |
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NOT BOTH |
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• 44 |
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44 |
Standard deduction from page 25 |
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.00 |
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.... |
• 45 |
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45 |
2012 federal tax liability ($0–$6,100; see instructions for the correct amount) |
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.00 |
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46 |
Other deductions and modifications. Identify: •46x |
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•46y |
$ |
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Schedule 46z |
• 46 |
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.00 |
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47 |
Add lines 43, 45, and 46 if itemizing. Otherwise, add lines 44, 45, and 46 |
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• 47 |
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.00 |
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48 |
Taxable income. Line 40 minus line 47 |
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• 48 |
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.00 |
OREGON |
49 |
Tax from tax charts. 49a |
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See instructions, page 27 |
• 49 |
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.00 |
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TAX |
50 |
Oregon income tax. Line 49 X Oregon percentage from line 39, or |
• 50 |
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.00 |
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Check if tax is from: • 50a |
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Form FIA-40P or • 50b |
Worksheet FCG |
• 51 |
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51 |
Interest on certain installment sales |
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• 52 |
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52 |
Total tax before credits. Add lines 50 and 51 |
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OREGON TAX➛ |
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.00 |
NONREFUNDABLE 53 |
Exemption credit. See instructions, page 28 |
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• 53 |
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.00 |
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CREDITS |
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................................ |
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• 54 |
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54 |
Child and dependent care credit. See instructions, page |
28 |
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.00 |
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ADD TOGETHER |
INCLUDE PROOF}55 |
Credit for income taxes paid to another state. State: •55y |
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Schedule 55z |
• 55 |
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.00 |
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Other credits. Identify: • 56x |
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•56y |
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• 56 |
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.00 |
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56 |
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$ |
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Schedule included 56z |
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• 57 |
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57 |
Total non-refundable credits. Add lines 53 through 56 |
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.00 |
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58 |
Net income tax. Line 52 minus line 57. If line 57 is more than line 52, enter -0- |
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• 58 |
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.00 |
PAYMENTS AND 59 |
Oregon income tax withheld from income. Include Forms W-2 and 1099 |
• 59 |
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.00 |
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REFUNDABLE |
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...... |
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• 60 |
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60 |
Estimated tax payments for 2012 and payments made with your extension |
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.00 |
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CREDITS |
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•60a Wolf depredation •60b Claim of right |
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.................. |
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• 61 |
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61 |
Tax payments from pass-through entity and real estate transactions |
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.00 |
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• 62 |
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ADD TOGETHER |
Include Schedule |
62 |
Earned income credit. See instructions, page 34 |
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.00 |
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WFC-N/P if you |
63 |
Working family child care credit from WFC-N/P, line 21 |
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• 63 |
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.00 |
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claim this credit |
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.................................... |
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• 64 |
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64 |
Mobile home park closure credit. Include Schedule MPC |
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.00 |
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• 65 |
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65 |
Total payments and refundable credits. Add lines 59 through 64 |
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.00 |
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66 |
Overpayment. Is line 58 less than line 65? If so, line 65 minus line 58 |
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OVERPAYMENT➛• 66 |
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67 |
Tax to pay. Is line 58 more than line 65? If so, line 58 minus line 65 |
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TAX TO PAY➛ |
• 67 |
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.00 |
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68 |
Penalty and interest for filing or paying late. See instructions, page 34 |
68 |
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.00 |
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ADD TOGETHER |
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69 |
Interest on underpayment of estimated tax. Include Form 10 and check box ...• 69 |
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Exception # from Form 10, line 1 •69a |
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Check box if you annualized •69b |
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70 |
Total penalty and interest due. Add lines 68 and 69 |
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70 |
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.00 |
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AMOUNT YOU OWE➛ • 71 |
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71 |
Amount you owe. Line 67 plus line 70 |
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.00 |
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72 |
Refund. Is line 66 more than line 70? If so, line 66 minus line 70 |
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REFUND➛ |
• 72 |
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.00 |
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73 |
Estimated tax. Fill in the part of |
line 72 you want applied to 2013 estimated tax |
• 73 |
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.00 |
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CHARITABLE |
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Prevent Child Abuse •74 |
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.00 |
Alzheimer’s Disease Research • 75 |
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CHECKOFF |
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Stop Dom. & Sexual Violence •76 |
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.00 |
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Habitat for Humanity • 77 |
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DONATIONS, |
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These will |
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PAGE 35 |
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OR Head Start Association •78 |
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.00 |
OR Military Financial Assist. • 79 |
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I want to donate |
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Oregon Historical Society •80 |
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.00 |
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Oregon Food Bank • 81 |
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.00 |
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your refund |
part of my tax |
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Albertina Kerr Kid’s Crisis Care •82 |
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American Red Cross • 83 |
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refund to the |
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following fund(s) |
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Charity code •84a |
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•84b |
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Charity code |
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•85a |
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•85b |
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.00 |
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...... |
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86 |
Total Oregon 529 College Savings Plan deposits. See instructions, page 35 |
• 86 |
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.00 |
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• 87 |
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87 |
Total. Add lines 73 through 86. Total can’t be more than your refund on line 72 |
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.00 |
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......................................... |
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NET REFUND➛ • 88 |
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88 |
NET REFUND. Line 72 minus line 87. This is your net refund |
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.00 |
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DIRECT |
89 |
For direct deposit of your refund, see instructions, page 35. |
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• Type of account: |
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Checking or |
Savings |
DEPOSIT |
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• Routing No. |
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• Account No. |
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Will this refund go to an account outside the |
United States? • |
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Yes |
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Important: Include a copy of your federal Form 1040, 1040A, 1040EZ, or 1040NR. |
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Under penalty for false swearing, I declare that the information in this return is true, correct, and complete. |
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Your signature |
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Date |
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Signature of preparer other than taxpayer |
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• License No. |
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X |
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X |
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Address |
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Telephone No. |
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Spouse’s/RDP's signature (if iling jointly, BOTH must sign) |
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Date |
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X |
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