State of Rhode Island Division of Taxation 
               2020 Form RI-PPP - Individual 
               Paycheck Protection Program Tax Return for an Individual

Your social security number                          Spouse’s social security number

Your first name                           MI    Last name                                   Suffix

Spouse’s name                             MI    Last name                                   Suffix

Address

City, town or post office                                 State ZIP code

FILING                                         Married filing                Married filing              Head of                                      Qualifying  
STATUS         Singleððððjointly                                             separately                  household                                    widow(er) ð
Check one
INCOME,        1     Modified Federal AGI from RI-1040 or RI-1040NR, line 3 ............................................................            1
TAX AND 
CREDITS
               2     Taxable portion of Paycheck Protection Program Loan Forgiveness amount (see below)...........                                  2
 Rhode  
 Island 
Standard       3     Adjusted Modified Federal AGI. Add lines 1 and 2 .......................................................................       3
Deduction 
 Single           4  RI Standard Deduction from left. If line 3 is over $ 207,700 see Standard Deduction Worksheet ...........                      4
 $8,900  
 Married 
filing jointly 5     Subtract line 4 from line 3.  If zero or less, enter 0........................................................................ 5
 or  
Qualifying 
widow(er)      6     Enter # of exemptions from RI Sch E, line 5 in box, multiply by $4,150 and          X $4,150 =                                 6
$17,800              enter result on line 6. If line 3 is over $207,700, see Exemption Worksheet
Married        7                                                                                                                                    7
  filing             RI TAXABLE INCOME. Subtract line 6 from line 5. If zero or less, enter 0...................................
separately 
 $8,900        8     RI income tax from Rhode Island Tax Table or Tax Computation Worksheet...............................                          8
Head of  
household            
$13,350        9     Total RI Tax from RI-1040, line 13a or RI-1040NR, line 16a ........................................................            9

               10    Additional Rhode Island Credits from Schedule CR.  Attach Schedule CR and documentation..                                      10

               11    Amount due.  Subtract lines 9 and 10 from line 8 .........................................................................     11

               Note: For line 2 - Taxable portion of Paycheck Protection Program Loan Forgiveness amount - enter your individual share of the Tax-
               able portion of the Paycheck Protection Program Loan Forgiveness amount received by the pass-through entity of which you are a 
               member or partner.  This amount comes from Form RI-PPP - Entity, Schedule C, Column E.  
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and 
belief, it is true, accurate and complete.  Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
 Your signature                                            Your driver’s license number     and    state      Date                        Telephone number

 Spouse’s signature                                        Spouse’s driver’s license number and state                Date                                    Telephone number

 Paid preparer signature                                           Print name                                          Date                                  Telephone number

 Paid preparer address                                        City, town or post office            State   ZIP code                                     PTIN

                               Mailing address: RI Division of Taxation, One Capitol Hill, Providence, RI 02908-5806