NOTE:
Effective for taxable years beginning after December 31, 1992, any portion of the amounts listed in
box 1 and/or box 2 which were claimed as a deduction on your prior year's tax return is disallowed and an
amended tax return for the prior year will have to be filed.
The amount listed in box 3 is an amount you used for other than a purchase of a first principal
residence and must be reported as Other Income on the Hawaii Income Tax Return that you file.
The amount on line 4 of this form must be included in your tax liability on your Hawaii Income Tax
Return.
The amount on line 5 of this form must be included in your Hawaii income tax withheld.
NOTE:
Effective for taxable years beginning after December 31, 1992, any portion of the amounts listed in
box 1 and/or box 2 which were claimed as a deduction on your prior year's tax return is disallowed and an
amended tax return for the prior year will have to be filed.
The amount listed in box 3 is an amount you used for other than a purchase of a first principal
residence and must be reported as Other Income on the Hawaii Income Tax Return that you file.
The amount on line 4 of this form must be included in your tax liability on your Hawaii Income Tax
Return.
The amount on line 5 of this form must be included in your Hawaii income tax withheld.
NOTE:
Effective for taxable years beginning after December 31, 1992, any portion of the amounts listed in
box 1 and/or box 2 which were claimed as a deduction on your prior year's tax return is disallowed and an
amended tax return for the prior year will have to be filed.
The amount listed in box 3 is an amount you used for other than a purchase of a first principal
residence and must be reported as Other Income on the Hawaii Income Tax Return that you file.
The amount on line 4 of this form must be included in your tax liability on your Hawaii Income Tax
Return.
The amount on line 5 of this form must be included in your Hawaii income tax withheld.