Income Calculation Worksheet - South Dakota Department Of Revenue & Regulation - 2007

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For Office Use Only
Tax Year
Type
Total Income
Batch Number
Refund
2006
Personal Information
First Name
Social Security Number
Last Name
Telephone
County
Mailing Address
State
Date of Birth (Month/Day/Year)
City
Zip Code
Income Calculation
Please list your income and its source in the area provided below.
Remember: July 1, 2007 is the deadline for filing.
Attach a copy of your complete 2006 federal income tax return.
Federal Adjusted Gross Income
$ _______________
Support Payments
$ _______________
Wages, salaries, tips, other employee
$ _______________
Cash public assistance and relief
$ _______________
compensation
Interest
$ _______________
Title 19
$ _______________
Capital gains excluded from
$ _______________
Dividends
$ _______________
adjusted gross income
Self-employment (explain)
$ _______________
Other income
$ _______________
Social Security (attach a copy of each
TOTAL INCOME
$ _______________
household member’s SSA-1099)
$ _______________
Medicare premiums
$ _______________
Deductions
SSI
$ _______________
For Home Owners
A portion of your real estate taxes will be deducted
Veteran’s benefits
$ _______________
from your income. List 2006 real estate taxes due
and payable in 2007.
$ _______________
Railroad retirement benefits
$ _______________
For Renters
A portion of your rent will be deducted from your
Other pensions and annuities
$ _______________
income. List the total rent that you alone have paid
in 2006.
$ _______________
Excluded interest and dividends
$ _______________
Alimony payments not yet listed
$ _______________

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