Form Pa-40 - Pa Schedule O - Other Deductions - 2013
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11301610059
PA SCHEDULE O
Other Deductions
PA-40 Schedule O
2013
(06-13) (FI)
OFFICIAL USE ONLY
Name shown first on the PA-40 (if filing jointly)
Social Security Number (shown first)
(See the instructions.)
PART I - IRC Section 529 Qualified Tuition Program Contributions (Limit $14,000 per beneficiary, per taxpayer-spouse.)
Beneficiary Information:
Contributions by:
Name:
Social Security Number
Taxpayer
Spouse
1.
1.
2. Total IRC Section 529 Contributions - Add all amounts listed (including amounts on
additional schedules).
2.
PART II - Other Deductions and Limitations
3. Medical Savings Account contributions allowed for federal purposes.
3.
4. Health Savings Account contributions allowed for federal purposes.
4.
5. Add Lines 2, 3 and 4 and enter amounts here for taxpayer and/or spouse.
5.
6. Total income reported on PA-40 Line 9 by taxpayer and spouse separately.
6.
7. Lesser of Line 5 or Line 6 for taxpayer and/or spouse.
7.
8. Total Other Deductions - Add the amounts from Line 7 for taxpayer and/or spouse together.
Enter here and on Line 10 of your PA-40.
8.
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