Form 40 - Oregon Individual Income Tax Return - 2013

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Clear Form
Amended Return
OREGON
2013
For office use only
Form
40
INDIVIDUAL INCOME TAX RETURN
Full-Year Residents Only
Fiscal year ending
K
F
P
J
H W
Last name
First name and initial
Date of birth
(mm/dd/yyyy)
Social Security No. (SSN)
Deceased
Spouse’s/RDP’s last name if joint return
Spouse’s/RDP’s first name and initial if joint return
Spouse’s/RDP’s SSN if joint return
Date of birth
(mm/dd/yyyy)
Deceased
Current mailing address
Telephone number
(
)
City
State
ZIP code
Country
If you filed a return last year, and your
name or address is different, check here
Filing
1
Exemptions
Single
Status
2a
Married filing jointly
Total
2b
Registered domestic partners (RDP) filing jointly
Check
6a
6a
Yourself ...........
Regular
...... Severely disabled
....
only
3a
Married filing separately:
one
6b
b
Spouse/RDP ...
Regular
...... Severely disabled
......
Spouse’s name _____________________________ Spouse’s SSN ___________________
box
3b
Registered domestic partner filing separately:
6c
c
All dependents
First names __________________________________
Partner’s name _____________________________ Partner’s SSN ___________________
6d
d
Disabled
First names __________________________________
4
Head of household:
Person who qualifies you ________________________________
children only
Total
6e
5
Qualifying widow(er) with dependent child
(see instructions)
7a
7b
You
7c
You have
7d
Someone else
You were:
65 or older
Blind
Check all that apply
filed an
federal
can claim you
Spouse/RDP was:
65 or older
Blind
extension
Form 8886
as a dependent
Round to the nearest dollar
8 Federal adjusted gross income. Federal Form 1040, line 37; 1040A, line 21; 1040EZ, line 4;
.00
1040NR, line 36; or 1040NR-EZ, line 10. See instructions, page 13 ...........................................................
8
.00
9 Interest and dividends on state and local government bonds outside of Oregon ...
9
ADDITIONS
.00
10y $
10 Other additions. Identify:
10x
10z
10
Schedule included
.00
11 Total additions. Add lines 9 and 10 .............................................................................................................
11
.00
12 Income after additions. Add lines 8 and 11 .................................................................................................
12
.00
13 2013 federal tax liability ($0–$6,250; see instructions for the correct amount) .....
13
SUBTRACTIONS
.00
Include
14 Social Security included on federal Form 1040, line 20b; or Form 1040A, line 14b ...
14
proof of
.00
15 Oregon income tax refund included in federal income ............................................
15
withholding
.00
16 Interest from U.S. government, such as Series EE, HH, and I bonds .....................
16
(W-2s,
.00
% ...
% 17b
1099s),
17 Federal pension income. See instructions, page 15. 17a
17
payment,
.00
18y $
18 Other subtractions. Identify:
18x
18z
18
Schedule included
and payment
.00
19 Total subtractions. Add lines 13 through 18 ................................................................................................
19
voucher
.00
20 Income after subtractions. Line 12 minus line 19 ........................................................................................
20
If you are claiming itemized deductions, fill in lines 21 and 23–25. If you are claiming the standard deduction, fill in line 26 only.
DEDUCTIONS
.00
21 Itemized deductions from federal Schedule A, line 29 ............................................
21
0
.00
Do not complete line 22
22
22
.00
23 Total Oregon itemized deductions. Add lines 21 and 22 .........................................
23
.00
24 State income tax claimed as an itemized deduction ..........................................
24
.00
25 Net Oregon itemized deductions. Line 23 minus line 24.........................................
25
Either line 25 or 26
OR
.00
26 Standard deduction from page 19 ...........................................................................
26
.00
27 Total deductions. Line 25 or line 26, whichever is larger .........................................................................
27
.00
28 Oregon taxable income. Line 20 minus line 27. If line 27 is more than line 20, enter -0- .........................
28
.00
TAX
29 Tax. See instructions, page 19. Enter tax here ........................................................
29
Check if tax is from: 29a
Tax tables or charts or
29b
Form FIA-40 or
29c
Worksheet FCG
.00
30 Interest on certain installment sales .........................................................................
30
.00
31 Total tax before credits. Add lines 29 and 30 ...................................
OREGON TAX BEFORE CREDITS
31
NOW GO TO THE BACK OF THE FORM
150-101-040 (Rev. 12-13)

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