TEST 1 – RI-1040NR 
  
Scenario: NY residents Henry (deceased) and Karen Hill with an address of 22 Broad Street, 
New York, NY 10001, are filing an amended Married Filing Jointly return with income from 
outside of RI.  TPs have a Federal AGI of $195,000.00. TPs have a balance due of $1,882.00. 
  
Additional information: 
SSN(s): 311-62-3644 & 272-15-3545 
Electoral Contribution :  YES 
Specific Party: YES R  
Exemption(s)  3 
Use tax certification checkbox is checked 
Estimates $300.00 
Nonresident Real Estate withholding: $400.00 
Other Payments $380.00 
Previously issued overpayments $250.00 
Primary license number and state: 098123456 - NY 
Spouse license number and state (if applicable): 078901234 - NY 
PTIN  P44335567 
Contact Preparer    YES 
Line 23 Child and dependent care expenses  $400.00 
Checkoff Contributions: 
 Drug program                  $1.00 
 Olympic                       $2.00 
 RI Organ                      $3.00 
 RI Council on the Arts        $4.00 
 Nongame Wildlife              $5.00 
 Childhood Disease             $6.00 
 Military Family               $3.00 
 Behavior Health               $4.00 
 
This test will use the following additional schedule(s) and form(s).  Use the data provided below 
to populate the schedule(s) and form(s).: 
RI Schedule II 
RI Schedule CR 
RI Schedule E 
RI Schedule M 
RI Schedule U 
RI Schedule W 
Form RI-2210  
  
                                                                Page   of 1                 12     
 

                            TEST 1 – RI-1040NR - continued 
  
 RI-1040NR Schedule II 
   Line 1a          $85,000.00              Line 7a        $-6,500.00 
   Line 1b          $106,250.00             Line 7b        $-5,000.00 
   Line 2a          $39,890.00              Line 8a        $230,740.00 
   Line 2b          $60,140.00              Line 8b        $276,250.00 
   Line 3a          $-15,000.00             Line 9a        $65,000.00 
   Line 3b          $-10,000.00             Line 9b        $81,250.00 
   Line 4a          $-25,000.00             Line 11a       $1,490.00 
   Line 4b          $-20,000.00             Line 11b       $1,490.00 
   Line 5a          $132,250.00             Line 13        0.8511 
   Line 5b          $102,698.00             Line 14        $6,877.00 
   Line 6a          $20,100.00              Line 15        $5,853.00 
   Line 6b          $42,162.00 
  
 RI Schedule CR 
   RI-0715          $125.00                 Recap #1       6754   
   RI-2276          $135.00                                QJobs                   
   RI-286B          $145.00                                $133.00 
   RI-5442          $100.00                 Recap #2       7253   
   RI-6754          $101.00                                Rebuild  
   RI-7253          $60.00                                 $117.00 
   RI-8201          $115.00 
   RI-9283          $120.00 
  
 RI Schedule E 
   “Yourself” checkbox is checked 
   “Spouse” checkbox is checked 
  Name of Dependent Social Security Number  Date of Birth  Relationship 
  Corey Hill        452081342               07102012       Daughter 
    
 RI Schedule M 
   Line 1a          $475.00                 Line 1s        03/06/1925 
   Line 1b          $125.00                                07/18/1930 
   Line 1c          $135.00                                $165.00 
   Line 1d          $150.00                 Line 1t        03/06/1925 
   Line 1e          $400.00                                07/18/1930 
   Line 1f          $0.00                                  $185.00 
   Line 1g          $265.00                 Line 1u        $490.00 
   Line 1h          $300.00                 Line 1v        $5,000.00 
   Line 1i          $320.00                 Line 2a        $5,500.00 
   Line 1j          $500.00                 Line 2b        $1,300.00 
   Line 1k          $445.00                 Line 2c        $1,200.00 
   Line 1l          $0.00                   Line 2d        $1,000.00 
   Line 1m          $400.00                 Line 2e        $615.00 
   Line 1n          $100.00                 Line 2f        $825.00 
   Line 1o          $520.00                 Line 2g        $765.00 
   Line 1p          $95.00                             Line 2h            $135.00 
   Line 1q          $565.00                 Line 2i        $435.00 
   Line 1r          $0.00                   Line 2j        $350.00 
                                            Line 2k        BLANK

                                                                                  Page   of 2 12 
  

                   TEST 1 – RI-1040NR - continued 
  
 RI Schedule U 
   Line 6        $156.00 
   Line 7e       $21.00 
   
 RI Schedule W  
   Line 1                Employer 1    121212121 1,125.00 
   Line 2        D       Employer 2    212121212 1,130.00 
   Line 3      S E       Employer 3    313131313 136.00
   Line 4        N       Employer 4    565656565 115.00
   Line 5      S         Employer 5    989898989 118.00
   Number of withholding documents – 5 
  
 RI-2210 
   Annualization of income checkbox is checked 
   Underestimating amount is $38.00 
  
                                                          Page   of 3 12 
  

                               TEST 2 – RI-1040NR 
 
Scenario: Part Year resident Frank Castle Sr (deceased) with a new address of 67 Ferry Lane, 
Queens, NY 11355 is filing an amended Head of Household return with income from outside of 
RI. TP has three dependents under the age of eighteen. TP did not have health insurance for 4 
months, and dependents were uninsured for a combined total of 11 months. TP owes $985.00 on 
line 15b. TP has a Federal AGI of $145,000.00.  TP has a balance due of $1,319.00. 
  
Additional information: 
SSN(s): 172-45-6279 
Electoral Contribution :  YES 
Specific Party: NO  
Exemption(s)  4 
Use tax certification checkbox is checked 
Estimates $260.00 
Nonresident Real Estate withholding: $500.00 
Other Payments $300.00 
Previously issued overpayments $175.00 
Primary license number and state: 987654321 - NY 
Spouse license number and state (if applicable):  
PTIN  P56789832 
Contact Preparer    YES 
Line 23 Child and dependent care expenses  $500.00 
Checkoff Contributions: 
 Drug program                  $5.00 
 Olympic                       $1.00 
 RI Organ                      $6.00 
 RI Council on the Arts        $8.00 
 Nongame Wildlife              $10.00 
 Childhood Disease             $12.00 
 Military Family               $15.00 
 Behavioral Health             $5.00 
 
Line 34 Federal EIC  $0.00 
 
This test will use the following additional schedule(s) and form(s).  Use the data provided below 
to populate the schedule(s) and form(s).: 
RI Schedule III 
RI Schedule CR 
RI Schedule E 
RI Schedule M 
RI Schedule U 
RI Schedule W 
Form RI-2210  
Form IND-HEALTH 
  
                                                                                   Page   of 4 12  
 

                       TEST 2 – RI-1040NR - continued 
  
RI-1040NR Schedule III 
 Part 1: 
 From          01/01/2024      Line 5d                $10,900.00 
 To            08/18/2024      Line 6a                $16,850.00 
 Line 1a       $70,000.00      Line 6b                $10,850.00 
 Line 1b       $45,000.00      Line 6c                $6,000.00 
 Line 1c       $25,000.00      Line 6d                $3,000.00 
 Line 1d       $10,000.00      Line 7a                $8,500.00 
 Line 2a       $-20,000.00     Line 7b                $5,000.00 
 Line 2b       $-15,000.00     Line 7c                $3,500.00 
 Line 2c       $-5,000.00      Line 7d                $1,550.00 
 Line 2d       $-2,500.00      Line 9a                $15,500.00 
 Line 3a       $-18,000.00     Line 9b                $9,500.00 
 Line 3b       $-12,000.00     Line 9c                $6,000.00 
 Line 3c       $-6,000.00      Line 9d                $2,350.00 
 Line 3d       $-3,200.00      Line 11a               $3,015.00 
 Line 4a       $52,500.00      Line 11b               $2,635.00 
 Line 4b       $37,000.00      Line 11c               $380.00 
 Line 4c       $15,500.00      Line 11d               $730.00 
 Line 4d       $7,200.00       Line 14                0.8105 
 Line 5a       $50,650.00      Line 15                $4,438.00 
 Line 5b       $30,650.00      Line 16                $3,597.00 
 Line 5c       $20,000.00 
 
 Part 2: 
 Line 18       $75,000.00 
 Line 22       MA   $1,500.00 
 Line 24       $125,000.00 
 Line 25       0.6000 
 Line 27       $900.00 
 Line 28       $2,697.00 
 
RI Schedule CR 
 RI-0715       $200.00 
 RI-2276       $100.00 
 RI-286B       $120.00 
 RI-5442       $90.00 
 RI-6754       $160.00 
 RI-7253       $115.00 
 RI-8201       $135.00 
 RI-9283       $140.00 
 Recap #1      $185.00 
 Recap #2      $215.00 
                
                                                                Page   of 5 12 
 

                      TEST 2 – RI-1040NR - continued 
  
 RI Schedule E 
   “Yourself” checkbox is checked 
  
  Name of Dependent Social Security Number  Date of Birth  Relationship 
  JOHN CASTLE       123221122               09162010       SON 
  SUZANNE CASTLE  445678999                 01262022       DAUGHTER
  RYAN CASTLE       243143342               07152014       SON 
  
 RI Schedule M
   Line 1a          $185.00                  Line 1s       10/31/1945 
   Line 1b          $210.00                                $105.00 
   Line 1c          $125.00                  Line 1t       10/31/1945 
   Line 1d          $200.00                                $100.00 
   Line 1e          $255.00                  Line 1u       $220.00 
   Line 1f          $0.00                    Line 1v       $215.00 
   Line 1g          $250.00                  Line 2a       $700.00 
   Line 1h          $325.00                  Line 2b       $750.00 
   Line 1i          $365.00                  Line 2c       $800.00 
   Line 1j          $390.00                  Line 2d       $850.00 
   Line 1k          $415.00                  Line 2e       $300.00 
   Line 1l          $0.00                    Line 2f       $1,315.00 
   Line 1m          $150.00                  Line 2g       $200.00 
   Line 1n          $125.00                            Line 2h            $875.00 
   Line 1o          $310.00                  Line 2i       $1,050.00 
   Line 1p          $400.00                  Line 2j       $635.00 
   Line 1q          $115.00                 Line 2k       BLANK                    
   Line 1r          $0.00 
  
 RI Schedule U 
   Using Option #1 
   Line 1           $15,000.00 
   Line 3           $285.00 
  
 RI Schedule W  
   Line 1                   Employer 1  112222222    510.00
   Line 2           E       Employer 2  113333333    675.00
   Line 3           D       Employer 3  114444444    200.00
   Line 4           R       Employer 4  115555555    125.00
   Line 5           M       Employer 5  116666666    135.00
   Number of withholding documents – 5 
  
 RI-2210 
   Farmer/Fisherman checkbox is checked 
   Underestimating amount is $0.00 
  
                                                                                  Page   of 6 12 
  

                    TEST 2 – RI-1040NR - continued 
 
Form IND-HEALTH 
     
    Frank:  
    No minimum essential coverage from January through April 
    HealthSource RI Exemption for May through July 
          Exemption certificate #: RI021120 
    Nonresident for the rest of the year 
 
    John: 
    No minimum essential coverage from January through June 
    Minimum essential coverage for July 
    Nonresident for the rest of the year 
    
    Suzanne: 
    Born in January 
    No minimum essential coverage from February through June 
    Minimum essential coverage for July 
    Nonresident for the rest of the year 
     
    Ryan 
    Minimum essential coverage from January through July 
    Nonresident for the rest of the year 
    
                                                             Page   of 7 12 
 

                                     TEST 3 – RI-1040NR 
  
Scenario: Part year resident Kevin Owens with an address of 19 Square Circle, San Diego, CA 
92103 is a filing married separately return. TP has a Federal AGI of $65,250.00.  TP has an 
overpayment of $723.00, of which $123.00 is being applied to 2025 estimated tax. 
 
Additional information: 
SSN(s): 246-81-3579 
Electoral Contribution :  NO 
Specific Party: NO  
Exemption(s)  1 
Use tax certification checkbox is checked. 
Individual Mandate checkbox is checked. 
Estimates $195.00 
Nonresident Real Estate withholding: $87.00 
Other Payments $100.00 
Previously issued overpayments $0.00 
Primary license number and state: 112233444 - CA 
Spouse license number and state (if applicable):  
PTIN  P34567899 
Contact Preparer    YES 
Line 23 Child and dependent care expenses  $0.00 
Checkoff Contributions: 
 Drug program                 $5.00 
 Olympic                      $1.00 
 RI Organ                     $16.00 
 RI Council on the Arts       $6.00 
 Nongame Wildlife             $3.00 
 Childhood Disease            $9.00 
 Military Family              $10.00 
 Behavioral Health            $10.00 
 
This test will use the following additional schedule(s) and form(s).  Use the data provided below 
to populate the schedule(s) and form(s).: 
RI Schedule III 
RI Schedule CR 
RI Schedule E 
RI Schedule M 
RI Schedule NR-MU 
RI Schedule U 
RI Schedule W

                                                                                 Page   of 8 12    
 

                        TEST 3 – RI-1040NR - continued 
  
 RI 1040NR Schedule III 
   Date From:   07/11/2024           Line 6c           $800.00 
   Date To:     12/31/2024           Line 6d           $140.00 
   Line 1a      $40,000.00           Line 7a           $6,050.00 
   Line 1b      $21,450.00           Line 7b           $2,050.00 
   Line 1c      $18,550.00           Line 7c           $4,000.00 
   Line 1d      $7,210.00            Line 7d           $2,000.00 
   Line 2a      $2,500.00            Line 9a           $5,000.00 
   Line 2b      $1,500.00            Line 9b           $3,200.00 
   Line 2c      $1,000.00            Line 9c           $1,800.00 
   Line 2d      $300.00              Line 9d           $600.00 
   Line 3a      $11,500.00           Line 11a          $-3,157.00 
   Line 3b      $7,000.00            Line 11b          $-2,557.00 
   Line 3c      $4,500.00            Line 11c          $-600.00 
   Line 3d      $150.00              Line 11d          $-300.00 
   Line 4a      $5,000.00            Line 12a          $62,093.00 
   Line 4b      $3,000.00            Line 13           $42,143.00 
   Line 4c      $2,000.00            Line 14           0.6787 
   Line 4d      $425.00              Line 15           $1,746.00 
   Line 5a      $3,200.00            Line 16           $1,185.00 
   Line 5b      $2,000.00            Line 18           $35,000.00 
   Line 5c      $1,200.00            Line 20           0.8445 
   Line 5d      $375.00              Line 22           MU 
   Line 6a      $2,000.00                              $510.00 
   Line 6b      $1,200.00            Line 24           $41,500.00 
   
 RI Schedule CR 
   RI-0715      $50.00              
   RI-2276      $70.00               
   RI-286B      $110.00              Recap #1          $135.00 
   RI-5442      $100.00              Recap #2          $145.00 
   RI-6754      $80.00 
   RI-7253      $150.00 
   RI-8201      $75.00 
   RI-9283      $90.00 
  
 RI Schedule E 
   “Yourself” checkbox is checked 
   
                                                                 Page   of 9 12 
  

                        TEST 3 – RI-1040NR - continued 
  
 RI Schedule M 
   Line 1a      $300.00                  Line 1s         05/22/1950                 
   Line 1b      $155.00                                  $300.00 
   Line 1c      $220.00                  Line 1t         05/22/1950                 
   Line 1d      $123.00                                  $250.00 
   Line 1e      $221.00                  Line 1u         $974.00 
   Line 1f      $0.00                    Line 1v         $0.00 
   Line 1g      $366.00                  Line 2a         $229.00 
   Line 1h      $178.00                  Line 2b         $102.00 
   Line 1i      $246.00                  Line 2c         $218.00 
   Line 1j      $167.00                  Line 2d         $260.00 
   Line 1k      $185.00                  Line 2e         $109.00 
   Line 1l      $0.00                    Line 2f         $293.00 
   Line 1m      $432.00                  Line 2g         $141.00 
   Line 1n      $99.00                              Line 2h           $125.00 
   Line 1o      $197.00                  Line 2i         $165.00 
   Line 1p      $125.00                  Line 2j         $211.00 
   Line 1q      $472.00                  Line 2k         BLANK
   Line 1r      $0.00 
  
 RI Schedule NR-MU 
  
   Income from MA while a RI resident   $20,000.00 
   Income from MA                       $21,500.00  
   Taxes paid to MA                     $300.00 
   Income from CT while a RI resident   $8,000.00 
   Income from CT                       $10,000.00 
   Taxes paid to CT                     $35.00 
   Income from VT while a RI resident   $7,000.00   
   Income from VT                       $10,000.00 
   Taxes paid to VT                     $175.00 
  
 RI Schedule U 
   Line 6       $45.00 
   Line 7e      $204.00 
   
 RI Schedule W  
   Line 1               Employer 1      991234567  425.00
   Line 2               Employer 2      992345678  300.00
   Line 3          D    Employer 3      995678912  125.00
   Line 4          K    Employer 4      996543789  75.00
   Line 5          I    Employer 5      990451237  35.00
   Number of withholding documents – 5 
  
                                                                              Page 10 of 12 
  

                               TEST 4 – RI-1040NR 

 Scenario: MA resident Jack Collins with an address of 50 Main St, Fall River, MA 02723 is filing a 
 single return with all income from RI.  TP has a Federal AGI of $38,475.00.  TP has an overpayment, 
 of which $433 is being applied to 2025 estimated tax.  Date of birth: 11/25/1969 
  
 Additional information: 
 SSN(s): 011-49-1179 
 Electoral Contribution :  NO 
 Specific Party: NO  
 Exemption(s)  2 
 Use tax certification checkbox is checked 
 Estimates $500.00 
 Nonresident Real Estate withholding: $400.00 
 Other Payments $600.00 
 Primary license number and state: M10629876 - MA 
 Spouse license number and state (if applicable):  
 PTIN  P75869213 
 Contact Preparer    YES 
 Checkoff Contributions: 
   Drug program                $14.00 
   Olympic                     $1.00 
   RI Organ                    $15.00 
   RI Council on the Arts      $20.00 
   Nongame Wildlife            $25.00 
   Childhood Disease           $30.00 
   Military Family             $25.00 
   Behavioral Health           $10.00 
  
 Line 34 Federal EIC  $589.00 
  
 This test will use the following additional schedule(s) and form(s).  Use the data provided below 
 to populate the schedule(s) and form(s).: 
 RI Schedule CR 
 RI Schedule E 
 RI Schedule M 
 RI Schedule U 
 RI Schedule W 
  
 RI Schedule CR 
   RI-286B           $500.00 
   
 RI Schedule E 
   “Yourself” checkbox is checked 
  Name of Dependent      Social Security Number    Date of Birth Relationship 
  JAMES COLLINS          575684536                 02142016      SON 
  
                                                                                  Page 11 of 12      
  

                        TEST 4 – RI-1040NR - continued 
  
 RI Schedule M 
   Line 1i      $2,000.00 
   
 RI Schedule U 
   Line 6       $25.00 
   Line 7e      $125.00 
  
 RI Schedule W  
  
   Line 1               Employer 1     123456789 180.00
   Line 2       P       Employer 2     999001212 50.00
   Number of withholding documents – 2 

                                                       Page 12 of 12