Test
Packet
Tax Year 2009
October 2009
|
Test
Packet
Tax Year 2009
October 2009
|
|
October 2, 2009
Dear Software Developers,
Attached is the 2009 Idaho 2D Barcode Test Packet.
Idaho testing will begin October 5, 2009.
Test results will be sent to you by e-mail within two workdays after receiving your test
returns.
Idaho 2-D test returns:
Include a cover letter requesting 2-D barcode approval with a contact person
name, phone number, and e-mail address with your forms.
Test returns can be submitted via e-mail as PDF attachments.
Final approval is not granted until the Tax Commission has the opportunity to run
developer test returns through the production scanner. This does not occur until
sometime in January. Software developers agree to make changes to software
packages up to this final approval date.
Idaho Substitute Form Approval
Include a cover letter requesting substitute forms approval with a contact person
name, phone number, and e-mail address with your forms.
Substitute forms will not be accepted by fax. Submit all substitute income tax
forms in PDF format to: substituteforms@tax.idaho.gov
Or in paper format to:
Substitute Forms Document Coordinator
Idaho State Tax Commission
800 Park Blvd, Plaza IV
Boise, ID 83712
Do not combine requests for 2-D barcode and substitute forms approval.
Our office hours are 7:00AM-3:30 PM MST.
Our office will be closed on weekends and the following holidays.
November 11 Veterans Day
November 26 Thanksgiving
December 25 Christmas
January 01 New Years Day
|
| If you find any errors or have questions regarding the test returns please contact Rene’ Holtslander by e-mail or phone. Please contact Chris Vega if you have any questions regarding the record layout. We look forward to working with you again this year! Sincerely, Rene’ Holtslander Chris Vega Electronic Filing Support Unit Electronic Filing Coordinator Idaho State Tax Commission Idaho State Tax Commission Revenue Operations Division Revenue Operations Division P O Box 36 P O Box 36 Boise Idaho83722 Boise 83722 Idaho (208)334-7787 desk(208) 334-7822desk (208)334-7560 fax(208) 334-7560fax rene.holtslander@tax.idaho.gov christopher.vega@tax.idaho.gov |
|
F 8734
O
R EFO0008940 2009
M 08-21-09-v10
IDAHO INDIVIDUAL INCOME TAX RETURN
State Use Only
AMENDED RETURN, check the box. .
See instructions, page 6 for the reasons
for amending and enter the number. .
Your Social Security Number (required)
For calendar year 2009, or fiscal year beginning , ending
Your first name and initial Last name 400-00-5950
TED N NOON Spouse's Social Security Number (required)
Spouse's first name and initial Last name
TYPEMailing address Taxpayer deceased Do you need Idaho
� in 2009 income tax forms
215 Laid Back Blvd
mailed to you next year?
City, State, and Zip Code Spouse deceased
PLEASE PRINT OR
Coeur D Alene ID 83814 � in 2009 . XYes . No
FILING STATUS. If filing married joint or separate return, enter spouse's name and Social Security number above.
1. X Single 2. Married filing joint return 3. Married filing separate return 4. Head of household 5. Qualifying widow(er)
6. EXEMPTIONS. If someone can claim you as a Enter "1" in boxes 6a, Yourself a. 0 Election campaign fund
dependent, leave box 6a blank. and 6b, if they apply.
Spouse b. I want $1 of my income tax to go to the Idaho
Election Campaign Fund ($2 on joint return).
c. List your dependents. If more than four dependents, continue on Form 39R.
Enter the total number here ................................................................................ c. 7. Yourself 8. Spouse 7. Yourself 8. Spouse
___________________________________________________________________ First name Last name Social Security Number
___________________________________________________________________ Constitution Republican
. .
___________________________________________________________________ Democratic No Specific
. .
___________________________________________________________________ Libertarian None
X . .
___________________________________________________________________
d. Total exemptions. Add lines 6a through 6c. Must match federal return ............ d. 0
INCOME. See instructions, page 7.
9. Enter your federal adjusted gross income from federal Form 1040, line 37; federal Form 1040A, line 21;
or federal Form 1040EZ, line 4. Attach a complete copy of your federal return ............................................ . 9 10000 00
10. Additions from Form 39R, Part A, line 6. Attach Form 39R ........................................................................... 10 00
11. Total. Add lines 9 and 10 ................................................................................................................................ 11 10000 00
12. Subtraction from Form 39R, Part B, line 23. Attach Form 39R ...................................................................... 12 00
13. TOTAL ADJUSTED INCOME. Subtract line 12 from line 11.
If you have an NOL and are electing to forego the carryback period, check here . ............................ 13 . 10000 00
TAX COMPUTATION. See instructions, page 7.
ATTACH PAYMENT HERE a. If age 65 or older ............................. .Yourself . Spouse
Standard 14. CHECK b. If blind ...............................................Yourself . Spouse
Deduction c. If your parent or someone else can claim you as a dependent,
For Most
People check here and enter zero on lines 20 and 46. .X
Single or 15. Itemized deductions. Attach federal Schedule A. Federal limits apply ................................. . 15 00
Married filing 16. All state and local income or general sales taxes included on
Separately:
$5,700 federal Schedule A, line 5 ...................................................................................................... .16 00
Head of 17. Subtract line 16 from line 15. If you do not use federal Schedule A, enter zero ................... 17 00
Household:
$8,350 18. Standard deduction. See instructions page 7 to determine standard deduction amount
if different than the Standard Deduction For Most People ..................................................... . 18 7200 00
Married filing
Jointly or 19. Subtract the LARGER of line 17 or 18 from line 13. If less than zero, enter zero ................. 19 2800 00
Qualifying
Widow(er): 20. Multiply $3,650 by the number of exemptions claimed on line 6d. Federal limits apply ....... . 20 00
$11,400
ATTACH STATE W-2 COPIES HERE 21. Taxable income. Subtract line 20 from line 19. If less than zero, enter zero ....................... . 21 2800 00
22. Tax from tables or rate schedule. See instructions, page 35 ................................................ . 22 76 00
Continue to page 2.
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise, ID 83756-0056
ATTACH A COMPLETE COPY OF YOUR FEDERAL RETURN. {¢S¦}
|
|
Form 40 - 2009 Page 2
EFO00089p2 08-31-09-v9
23. Tax amount from line 22 ............................................................................................................................................ 23 76 00
CREDITS. Limits apply. See instructions, page 8.
24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns . 24 00
25. Credit for contributions to Idaho educational entities ...................................................... . 25 00
26. Credit for contributions to Idaho youth and rehabilitation facilities .................................. . 26 00
27. Credit for live organ donation expenses ...........................................................................27 00
28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 ......... 28 00
29. TOTAL CREDITS. Add lines 24 through 28 ............................................................................................................. 29 00
30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero .................................................................. 30 76 00
OTHER TAXES. See instructions, page 9.
31. Fuels tax due. Attach Form 75 ................................................................................................................................. 31 00
32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases .............................................................. .32 00
33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 .................................. 33 00
34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER .................................................... .34 00
35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments .................. . 35 1000
36. TOTAL TAX. Add lines 30 through 35 ....................................................................................................................... . 36 86 00
DONATIONS. See instructions, page 9. I wish to donate to:
37. Nongame Wildlife Conservation Fund ........... .________ 5 38. Idaho Children's Trust Fund ............ ._________5
39. Special Olympics Idaho ................................. .________ 5 40. Idaho Guard and Reserve Family ... ._________5
41. American Red Cross of Greater Idaho Fund .. .________ 5 42. Veterans Support Fund ................... ._________5
43. Idaho Foodbank ............................................ ________ .5
44. Enter total donations. Add lines 37 through 43 ........................................................................................................ 44 35 00
45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................ 45 121 00
PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.
46. Grocery credit. Computed Amount (from worksheet) .................................................................. ______________.
To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46. .
To receive your grocery credit, enter the computed amount on line 46 .................................................................... .46 00
47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ............... . 47 00
48. Special fuels tax refund ________________ Gasoline tax refund ___________________ Attach Form 75 48 00
49. Idaho income tax withheld. Attach Form(s) W-2 ...................................................................................................... .49 00
50. 2009 Form 51 payment(s) and amount applied from 2008 return ............................................................................. .50 00
51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 .................................................................... 51 00
TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.
52. TAX DUE. Subtract line 51 from line 45 ......................................................................................................... .
121 00
53. Penalty ____________ Interest from the due date ____________ Enter total ..............................................
. 10 . 5 53 00
15
Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account .................... .
54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ...... . 54 136 00
55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid ....................................................... .55 00
56. REFUND. Amount of line 55 to be refunded to you ....................................................................................... .
00
57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ...................................................... .57 00
58. DIRECT DEPOSIT. See instructions, page 12. . Check if final deposit destination is outside the U.S. Type of .Checking
. Routing No. . Account No. Account:
.Savings
AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.
59. Total due (line 54) or overpaid (line 55) on this return ............................................................................................... 59 00
60. Refund from original return plus additional refunds ................................................................................................... 60 00
61. Tax paid with original return plus additional tax paid ................................................................................................. 61 00
62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 .................................................................... 62 00
. Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
SIGN Your signature Spouse's signature (if a joint return, BOTH MUST SIGN)
HERE . .
Date Daytime phone Preparer's EIN, SSN, or PTIN
.
Paid preparer's signature Address and phone number
. {¢U¦}
|
|
Form 39R - 2009
EFO00088p2
06-26-09-v5 Page 2
Name(s) as shown on return Social Security Number
Noon 400-00-5950
D. Credit for Income Tax Paid to Other States. See instructions, page 25.
This credit is being claimed for taxes paid to: . __________________________________ (State name)
1. Idaho tax, line 22, Form 40 ........................................................................ 1 00 Attach a copy of the
2. Other state's adjusted income .................................................................... .2 00 income tax return and a
separate Form 39R for
3. Idaho adjusted income from line 13, Form 40 ............................................ 3 00 each state for which a
4. Divide line 2 by line 3. Enter percentage here ........................................... 4 % credit is claimed.
5. Multiply line 1 by line 4. Enter amount here .................................................................................... 5 00
6. Other state's tax due less its income tax credits ............................................................................. .6 00
7. Enter the smaller of lines 5 or 6 here and on line 24, Form 40 ....................................................... . 7 00
E. Maintaining a Home for a Family Member Age 65 or Older, or a Family Member With a
Developmental Disability. See instructions, page 25.
1. Did you maintain a home for an immediate family member age 65 or older and provide more than
one-half of his/her support? You and your spouse do not qualify .................................................. Yes No
2. Did you maintain a home for an immediate family member with a developmental disability and
provide more than one-half of his/her support? You and your spouse may qualify ........................ Yes No
3. List each family member you are claiming:
Check here if
Name of Family Member Social Security Number Relationship to Person Date of Birth ofdevelopmentally
First Name Last Name of Family Member Filing Return Family Member disabled
4. Total amount claimed ($100 for each qualifying member but not more than $300).
Enter on line 47, Form 40. (Credit cannot be claimed if you took $1,000 deduction on
Part B, line 15.) ..................................................................................................................... 4 00
F. Dependents: (Continued from Form 40, page 1)
First Name Last Name Social Security Number
G. From Standard Deduction Worksheet on page ?? of the instructions.
1. Real estate taxes included in standard deduction ........................................................................... �1 500 00
2. Disaster loss included in standard deduction .................................................................................. �2 500 00
3. Qualified motor vehicle tax included in standard deduction ............................................................ �3 500 00
4. Total of lines 1 through 3 ................................................................................................................. 4 1500 00
|
|
F 8734
O
R EFO0008940 2009
M 08-21-09-v10
IDAHO INDIVIDUAL INCOME TAX RETURN
State Use Only
AMENDED RETURN, check the box. .
See instructions, page 6 for the reasons
for amending and enter the number. .
Your Social Security Number (required)
For calendar year 2009, or fiscal year beginning , ending
Your first name and initial Last name 400-00-5951
SAM N COOK Spouse's Social Security Number (required)
Spouse's first name and initial Last name
TYPEMailing address Taxpayer deceased Do you need Idaho
� in 2009 income tax forms
121 Torch Rd
mailed to you next year?
City, State, and Zip Code Spouse deceased
PLEASE PRINT OR
Boise ID 83702 � in 2009 . XYes . No
FILING STATUS. If filing married joint or separate return, enter spouse's name and Social Security number above.
1. Single 2. Married filing joint return 3. Married filing separate return 4. Head of household 5. X Qualifying widow(er)
6. EXEMPTIONS. If someone can claim you as a Enter "1" in boxes 6a, Yourself a. 1 Election campaign fund
dependent, leave box 6a blank. and 6b, if they apply.
Spouse b. I want $1 of my income tax to go to the Idaho
Election Campaign Fund ($2 on joint return).
c. List your dependents. If more than four dependents, continue on Form 39R.
Enter the total number here ................................................................................ c.10 7. Yourself 8. Spouse 7. Yourself 8. Spouse
___________________________________________________________________ First name Last name Social Security Number
___________________________________________________________________ Sally Cook 400 00 5962 Constitution RepublicanX
. .
___________________________________________________________________ Suzy Cook 400 00 5963 Democratic No Specific
. .
___________________________________________________________________Sammy Cook 400 00 5964 Libertarian None
. .
___________________________________________________________________Sandy Cook 400 00 5965
d. Total exemptions. Add lines 6a through 6c. Must match federal return ............ d. 11
INCOME. See instructions, page 7.
9. Enter your federal adjusted gross income from federal Form 1040, line 37; federal Form 1040A, line 21;
or federal Form 1040EZ, line 4. Attach a complete copy of your federal return ............................................ . 9 71913 00
10. Additions from Form 39R, Part A, line 6. Attach Form 39R ........................................................................... 10 35899 00
11. Total. Add lines 9 and 10 ................................................................................................................................ 11 107812 00
12. Subtraction from Form 39R, Part B, line 23. Attach Form 39R ...................................................................... 12 36859 00
13. TOTAL ADJUSTED INCOME. Subtract line 12 from line 11.
If you have an NOL and are electing to forego the carryback period, check here . ............................ 13 . 70953 00
TAX COMPUTATION. See instructions, page 7.
ATTACH PAYMENT HERE a. If age 65 or older ............................. .XYourself . Spouse
Standard 14. CHECK b. If blind ............................................... Yourself . Spouse
Deduction c. If your parent or someone else can claim you as a dependent,
For Most
People check here and enter zero on lines 20 and 46. .
Single or 15. Itemized deductions. Attach federal Schedule A. Federal limits apply ................................. . 15 35544 00
Married filing 16. All state and local income or general sales taxes included on
Separately:
$5,700 federal Schedule A, line 5 ...................................................................................................... .16 3000 00
Head of 17. Subtract line 16 from line 15. If you do not use federal Schedule A, enter zero ................... 17 32544 00
Household:
$8,350 18. Standard deduction. See instructions page 7 to determine standard deduction amount
if different than the Standard Deduction For Most People ..................................................... . 18 00
Married filing
Jointly or 19. Subtract the LARGER of line 17 or 18 from line 13. If less than zero, enter zero ................. 19 38409 00
Qualifying
Widow(er): 20. Multiply $3,650 by the number of exemptions claimed on line 6d. Federal limits apply ....... . 20 40150 00
$11,400
ATTACH STATE W-2 COPIES HERE 21. Taxable income. Subtract line 20 from line 19. If less than zero, enter zero ....................... . 21 00
22. Tax from tables or rate schedule. See instructions, page 35 ................................................ . 22 00
Continue to page 2.
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise, ID 83756-0056
ATTACH A COMPLETE COPY OF YOUR FEDERAL RETURN. {¢S¦}
|
|
Form 40 - 2009 Page 2
EFO00089p2 08-31-09-v9
23. Tax amount from line 22 ............................................................................................................................................ 23 00
CREDITS. Limits apply. See instructions, page 8.
24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns . 24 00
25. Credit for contributions to Idaho educational entities ...................................................... . 25 00
26. Credit for contributions to Idaho youth and rehabilitation facilities .................................. . 26 00
27. Credit for live organ donation expenses ...........................................................................27 00
28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 ......... 28 00
29. TOTAL CREDITS. Add lines 24 through 28 ............................................................................................................. 29 00
30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero .................................................................. 30 00
OTHER TAXES. See instructions, page 9.
31. Fuels tax due. Attach Form 75 ................................................................................................................................. 31 00
32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases .............................................................. .32 00
33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 .................................. 33 00
34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER .................................................... .34 00
35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments .................. . 35 1000
36. TOTAL TAX. Add lines 30 through 35 ....................................................................................................................... . 36 10 00
DONATIONS. See instructions, page 9. I wish to donate to:
37. Nongame Wildlife Conservation Fund ........... .________ 38. Idaho Children's Trust Fund ............ ._________
39. Special Olympics Idaho ................................. .________ 40. Idaho Guard and Reserve Family ... ._________
41. American Red Cross of Greater Idaho Fund .. .________ 42. Veterans Support Fund ................... ._________
43. Idaho Foodbank ............................................ ________ .
44. Enter total donations. Add lines 37 through 43 ........................................................................................................ 44 00
45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................ 45 10 00
PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.
46. Grocery credit. Computed Amount (from worksheet) .................................................................. ______________. 680
To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46. . X 0
To receive your grocery credit, enter the computed amount on line 46 .................................................................... .46 00
47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ............... . 47 00
48. Special fuels tax refund ________________ Gasoline tax refund ___________________ Attach Form 75 48 00
49. Idaho income tax withheld. Attach Form(s) W-2 ...................................................................................................... .49 2000 00
50. 2009 Form 51 payment(s) and amount applied from 2008 return ............................................................................. .50 00
51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 .................................................................... 51 00
TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.
52. TAX DUE. Subtract line 51 from line 45 ......................................................................................................... .
00
. . 53 00
53. Penalty ____________ Interest from the due date ____________ Enter total ..............................................
Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account .................... .
54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ...... . 54 00
55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid ....................................................... .55 1990 00
56. REFUND. Amount of line 55 to be refunded to you ....................................................................................... .
1990 00
57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ...................................................... .57 00
58. DIRECT DEPOSIT. See instructions, page 12. . xCheck if final deposit destination is outside the U.S. Type of .XChecking
. Routing No.836 0 54968 6 . Account No. 8 943 2668 0 8 0 2 312 1 Account:
. Savings
AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.
59. Total due (line 54) or overpaid (line 55) on this return ............................................................................................... 59 00
60. Refund from original return plus additional refunds ................................................................................................... 60 00
61. Tax paid with original return plus additional tax paid ................................................................................................. 61 00
62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 .................................................................... 62 00
. Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
SIGN Your signature Spouse's signature (if a joint return, BOTH MUST SIGN)
HERE . .
Date Daytime phone Preparer's EIN, SSN, or PTIN
.
Paid preparer's signature Address and phone number
. {¢U¦}
|
|
F
O IDAHO SUPPLEMENTAL SCHEDULE
R39R 2009
MEFO00088 For Form 40, Resident Returns Only
06-25-09 v4
Name(s) as shown on return Social Security Number
Sam Cook 400-00-5951
A. Additions. See instructions, page 21.
1. Federal net operating loss carryover included in line 9, Form 40 ..................................................... . . . . . 1 00
2. Capital loss carryover incurred outside the state before becoming an Idaho resident ..................... 2 100 00
3. Non-Idaho state and local bond interest and dividends .................................................................... 3 34444 00
4. Idaho college savings account withdrawal ........................................................................................ 4 1255 00
5. Other additions. Attach explanation ................................................................................................ 5 100 00
6. Total additions. Add lines 1 through 5. Enter on line 10, Form 40 .................................................. . 6 35899 00
B. Subtractions. See instructions, page 21.
1. Idaho net operating loss carryover . .
Idaho net operating loss carryback Enter total here ................................... 1 00
2. State income tax refund if included in federal income ....................................................................... . . . 2 100 00
3. Interest from U.S. Government obligations ....................................................................................... 3 50 00
4. Insulation of Idaho residence ............................................................................................................ 4 800 00
5. Alternative energy devices deduction
Year
Acquired Type of Device Total Cost Percent
a. 2009 $ X 40% = 5a500 00
b. 2008 $ X 20% = 5b500 00
c. 2007 $ X 20% = 5c500 00
d. 2006 $ X 20% = 5d500 00
e. Add lines 5a through 5d ................................................................................................................ . . . 5e 2000 00
6. Child/dependent care. Attach federal Form 2441 or 1040A, Schedule 2 .......................................... 6 2250 00
7. Social security and railroad benefits, if included in federal income ................................................... 7 3000 00
8. Retirement benefits deduction. Complete Part C ............................................................................. . . . . . 8 00
9. Technological equipment donation .................................................................................................... 9 00
10. Idaho capital gains deduction. Attach Form CG ............................................................................... 10 19959 00
11. Active duty military pay earned outside of Idaho ............................................................................... 11 1000 00
12. Adoption expenses ............................................................................................................................ 12 2000 00
13. Idaho medical savings account. Contributions Interest
Financial institution Account number . . . . . . . . . .13 500 00
14. Idaho college savings program ......................................................................................................... 14 500 00
15. Maintaining a home for the aged and/or developmentally disabled .................................................. 15 00
16. Idaho lottery winnings, less than $600 per prize ............................................................................... 16 600 00
17. Income earned on a reservation by an American Indian .................................................................. 17 1100 00
18. Health insurance premiums ............................................................................................................... 18 300 00
19. Long-term care insurance ................................................................................................................. 19 1000 00
20. Worker's compensation insurance .................................................................................................... 20 200 00
21. Bonus depreciation. Attach computations ........................................................................................ 21 1000 00
22. Other subtractions. Attach explanation ............................................................................................. 22 500 00
23. Total subtractions. Add lines 1 through 4 and 5e through 22.
Enter on line 12, Form 40 .................................................................................................................. . 23 36859 00
C. Retirement Benefits Deduction. See instructions, page 22, for qualified retirement benefits.
1. If single enter $27,876, or if married filing jointly enter $41,814 ................ . . .1 00
2. Federal Railroad Retirement benefits received .......................................... 2 00
3. Social Security benefits received ............................................................... 3 00
4. Line 1 minus lines 2 and 3. If less than zero enter zero ............................ 4 00
5. Qualified retirement benefits included in federal income ............................ . 5 00
6. Enter the smaller of line 4 or 5 here and on line 8, Part B ................................................................ 6 00
|
|
Form 39R - 2009
EFO00088p2
06-26-09-v5 Page 2
Name(s) as shown on return Social Security Number
Sam Cook 400-00-5951
D. Credit for Income Tax Paid to Other States. See instructions, page 25.
This credit is being claimed for taxes paid to: . __________________________________ (State name)
1. Idaho tax, line 22, Form 40 ........................................................................ 1 00 Attach a copy of the
2. Other state's adjusted income .................................................................... .2 00 income tax return and a
separate Form 39R for
3. Idaho adjusted income from line 13, Form 40 ............................................ 3 00 each state for which a
4. Divide line 2 by line 3. Enter percentage here ........................................... 4 % credit is claimed.
5. Multiply line 1 by line 4. Enter amount here .................................................................................... 5 00
6. Other state's tax due less its income tax credits ............................................................................. .6 00
7. Enter the smaller of lines 5 or 6 here and on line 24, Form 40 ....................................................... . 7 00
E. Maintaining a Home for a Family Member Age 65 or Older, or a Family Member With a
Developmental Disability. See instructions, page 25.
1. Did you maintain a home for an immediate family member age 65 or older and provide more than
one-half of his/her support? You and your spouse do not qualify .................................................. Yes No
2. Did you maintain a home for an immediate family member with a developmental disability and
provide more than one-half of his/her support? You and your spouse may qualify ........................ Yes No
3. List each family member you are claiming:
Check here if
Name of Family Member Social Security Number Relationship to Person Date of Birth of developmentally
First Name Last Name of Family Member Filing Return Family Member disabled
4. Total amount claimed ($100 for each qualifying member but not more than $300).
Enter on line 47, Form 40. (Credit cannot be claimed if you took $1,000 deduction on
Part B, line 15.) ..................................................................................................................... 4 00
F. Dependents: (Continued from Form 40, page 1)
First Name Last Name Social Security Number
Tammy Cook 400 00 5966
Andy Cook 400 00 5967
Brandy Cook 400 00 5968
Candy Cook 400 00 5969
Willy Cook 400 00 5970
Billy Cook 400 00 5971
G. From Standard Deduction Worksheet on page ?? of the instructions.
1. Real estate taxes included in standard deduction ........................................................................... �1 00
2. Disaster loss included in standard deduction .................................................................................. �2 00
3. Qualified motor vehicle tax included in standard deduction ............................................................ �3 00
4. Total of lines 1 through 3 ................................................................................................................. 4 00
|
|
F 8734
O
R EFO0008940 2009
M 08-21-09-v10
IDAHO INDIVIDUAL INCOME TAX RETURN
State Use Only
AMENDED RETURN, check the box. .
See instructions, page 6 for the reasons
for amending and enter the number. .
Your Social Security Number (required)
For calendar year 2009, or fiscal year beginning , ending
Your first name and initial Last name 400-00-5952
DENNIS A COX Spouse's Social Security Number (required)
Spouse's first name and initial Last name
400-00-5953
EDNA K COX
TYPEMailing address Taxpayer deceased Do you need Idaho
� in 2009 income tax forms
9374 Blue Heron
mailed to you next year?
City, State, and Zip Code Spouse deceased
PLEASE PRINT OR
MIDDLETON ID 83644 � in 2009 . Yes . Nox
FILING STATUS. If filing married joint or separate return, enter spouse's name and Social Security number above.
1. Single 2. X Married filing joint return 3. Married filing separate return 4. Head of household 5. Qualifying widow(er)
6. EXEMPTIONS. If someone can claim you as a Enter "1" in boxes 6a, Yourself a. 1 Election campaign fund
dependent, leave box 6a blank. and 6b, if they apply.
Spouse b. I want $1 of my income tax to go to the Idaho
1 Election Campaign Fund ($2 on joint return).
c. List your dependents. If more than four dependents, continue on Form 39R.
Enter the total number here ................................................................................ c. 7. Yourself 8. Spouse 7. Yourself 8. Spouse
___________________________________________________________________ First name Last name Social Security Number
___________________________________________________________________ Constitution X X Republican
. .
___________________________________________________________________ Democratic No Specific
. .
___________________________________________________________________ Libertarian None
. .
___________________________________________________________________
d. Total exemptions. Add lines 6a through 6c. Must match federal return ............ d. 2
INCOME. See instructions, page 7.
9. Enter your federal adjusted gross income from federal Form 1040, line 37; federal Form 1040A, line 21;
or federal Form 1040EZ, line 4. Attach a complete copy of your federal return ............................................ . 9 50000 00
10. Additions from Form 39R, Part A, line 6. Attach Form 39R ........................................................................... 10 00
11. Total. Add lines 9 and 10 ................................................................................................................................ 11 50000 00
12. Subtraction from Form 39R, Part B, line 23. Attach Form 39R ...................................................................... 12 00
13. TOTAL ADJUSTED INCOME. Subtract line 12 from line 11.
If you have an NOL and are electing to forego the carryback period, check here . ............................ 13 . 50000 00
TAX COMPUTATION. See instructions, page 7.
ATTACH PAYMENT HERE a. If age 65 or older ............................. .Yourself . Spouse
Standard 14. CHECK b. If blind ...............................................Yourself .X Spouse
Deduction c. If your parent or someone else can claim you as a dependent,
For Most
People check here and enter zero on lines 20 and 46. .
Single or 15. Itemized deductions. Attach federal Schedule A. Federal limits apply ................................. . 15 00
Married filing 16. All state and local income or general sales taxes included on
Separately:
$5,700 federal Schedule A, line 5 ...................................................................................................... .16 00
Head of 17. Subtract line 16 from line 15. If you do not use federal Schedule A, enter zero ................... 17 00
Household:
$8,350 18. Standard deduction. See instructions page 7 to determine standard deduction amount
if different than the Standard Deduction For Most People ..................................................... . 18 12500 00
Married filing
Jointly or 19. Subtract the LARGER of line 17 or 18 from line 13. If less than zero, enter zero ................. 19 37500 00
Qualifying
Widow(er): 20. Multiply $3,650 by the number of exemptions claimed on line 6d. Federal limits apply ....... . 20 7300 00
$11,400
ATTACH STATE W-2 COPIES HERE 21. Taxable income. Subtract line 20 from line 19. If less than zero, enter zero ....................... . 21 30200 00
22. Tax from tables or rate schedule. See instructions, page 35 ................................................ . 22 1779 00
Continue to page 2.
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise, ID 83756-0056
ATTACH A COMPLETE COPY OF YOUR FEDERAL RETURN. {¢S¦}
|
|
Form 40 - 2009 Page 2
EFO00089p2 08-31-09-v9
23. Tax amount from line 22 ............................................................................................................................................ 23 1779 00
CREDITS. Limits apply. See instructions, page 8.
24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns . 24 100 00
25. Credit for contributions to Idaho educational entities ...................................................... . 25 100 00
26. Credit for contributions to Idaho youth and rehabilitation facilities .................................. . 26 100 00
27. Credit for live organ donation expenses ...........................................................................27 00
28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 ......... 28 385 00
29. TOTAL CREDITS. Add lines 24 through 28 ............................................................................................................. 29 685 00
30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero .................................................................. 30 1094 00
OTHER TAXES. See instructions, page 9.
31. Fuels tax due. Attach Form 75 ................................................................................................................................. 31 88 00
32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases .............................................................. .32 56 00
33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 .................................. 33 75 00
34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER .................................................... .34 00
35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments .................. . 35 1000
36. TOTAL TAX. Add lines 30 through 35 ....................................................................................................................... . 36 1313 00
DONATIONS. See instructions, page 9. I wish to donate to:
37. Nongame Wildlife Conservation Fund ........... .________ 38. Idaho Children's Trust Fund ............ ._________
39. Special Olympics Idaho ................................. .________ 40. Idaho Guard and Reserve Family ... ._________
41. American Red Cross of Greater Idaho Fund .. .________ 42. Veterans Support Fund ................... ._________
43. Idaho Foodbank ............................................ ________ .
44. Enter total donations. Add lines 37 through 43 ........................................................................................................ 44 00
45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................ 45 1313 00
PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.
46. Grocery credit. Computed Amount (from worksheet) .................................................................. ______________. 80
To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46. . 80
To receive your grocery credit, enter the computed amount on line 46 .................................................................... .46 00
47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ............... . 47 100 00
48. Special fuels tax refund ________________ 79 Gasoline tax refund ___________________ 75 Attach Form 75 48 154 00
49. Idaho income tax withheld. Attach Form(s) W-2 ...................................................................................................... .49 4000 00
50. 2009 Form 51 payment(s) and amount applied from 2008 return ............................................................................. .50 200 00
51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 .................................................................... 51 4514 00
TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.
52. TAX DUE. Subtract line 51 from line 45 ......................................................................................................... .
00
. . 53 00
53. Penalty ____________ Interest from the due date ____________ Enter total ..............................................
Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account .................... .
54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ...... . 54 00
55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid ....................................................... .55 3221 00
56. REFUND. Amount of line 55 to be refunded to you ....................................................................................... . 3221
00
57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ...................................................... .57 00
58. DIRECT DEPOSIT. See instructions, page 12. . X Check if final deposit destination is outside the U.S. Type of . Checking
. Savings
. Routing No.6 8 6 94506 8 . Account No. 9 2 132 0808 6 6 2 3 498 3 Account: X
AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.
59. Total due (line 54) or overpaid (line 55) on this return ............................................................................................... 59 00
60. Refund from original return plus additional refunds ................................................................................................... 60 00
61. Tax paid with original return plus additional tax paid ................................................................................................. 61 00
62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 .................................................................... 62 00
. Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
SIGN Your signature Spouse's signature (if a joint return, BOTH MUST SIGN)
HERE . .
Date Daytime phone Preparer's EIN, SSN, or PTIN
.
Paid preparer's signature Address and phone number
. {¢U¦}
|
|
Form 39R - 2009
EFO00088p2
06-26-09-v5 Page 2
Name(s) as shown on return Social Security Number
Dennis Cox 400-00-5952
D. Credit for Income Tax Paid to Other States. See instructions, page 25.
This credit is being claimed for taxes paid to: . __________________________________ (State name)
1. Idaho tax, line 22, Form 40 ........................................................................ 1 00 Attach a copy of the
2. Other state's adjusted income .................................................................... .2 00 income tax return and a
separate Form 39R for
3. Idaho adjusted income from line 13, Form 40 ............................................ 3 00 each state for which a
4. Divide line 2 by line 3. Enter percentage here ........................................... 4 % credit is claimed.
5. Multiply line 1 by line 4. Enter amount here .................................................................................... 5 00
6. Other state's tax due less its income tax credits ............................................................................. .6 00
7. Enter the smaller of lines 5 or 6 here and on line 24, Form 40 ....................................................... . 7 00
E. Maintaining a Home for a Family Member Age 65 or Older, or a Family Member With a
Developmental Disability. See instructions, page 25.
1. Did you maintain a home for an immediate family member age 65 or older and provide more than
one-half of his/her support? You and your spouse do not qualify .................................................. Yes No
2. Did you maintain a home for an immediate family member with a developmental disability and
provide more than one-half of his/her support? You and your spouse may qualify ........................ Yes No
3. List each family member you are claiming:
Check here if
Name of Family Member Social Security Number Relationship to Person Date of Birth ofdevelopmentally
First Name Last Name of Family Member Filing Return Family Member disabled
Elvira Cox 123-45-9876 Mother 1934
4. Total amount claimed ($100 for each qualifying member but not more than $300).
Enter on line 47, Form 40. (Credit cannot be claimed if you took $1,000 deduction on
Part B, line 15.) ..................................................................................................................... 4 00
F. Dependents: (Continued from Form 40, page 1)
First Name Last Name Social Security Number
G. From Standard Deduction Worksheet on page ?? of the instructions.
1. Real estate taxes included in standard deduction ........................................................................... �1 00
2. Disaster loss included in standard deduction .................................................................................. �2 00
3. Qualified motor vehicle tax included in standard deduction ............................................................ �3 00
4. Total of lines 1 through 3 ................................................................................................................. 4 00
|
|
F
O IDAHO FUELS USE REPORT
R 75EFO00055
M 07-03-08
Name Social Security Number
PLEASE Dennis Cox
PRINT Assumed Business Name (DBA) 400 00 59 52
OR Federal Employer Identification Number
TYPE Address
9374 Blue Heron
City, State, and Zip Code
Middleton ID 83644
State use only
Section I. FILING PERIOD Beginning ______, _______ and ending � ______, _______
If you have already claimed a refund of this tax from the Tax Commission on another Form 75,
do not complete this form.
Section II. BUSINESS ACTIVITIES Mark each box below that describes the business activities of your company.
1. � X Farming 6. � Landscaping & tree service 11. � Golf course
2. � Logging 7. � Well drilling 12. � Outfitter
3. � Construction 8. � Equipment rental/leasing 13. � Mining
4. � Trucking 9. � Concrete/asphalt/gravel 14. � XOther (describe) ________
5. � Manufacturing 10. � Excavating Crop Dusting
Section III. NONTAXABLE USE Mark each box below that describes the nontaxable use(s) to claim a refund of fuels taxes.
IDAHO TAX-PAID special fuels (diesel, propane, or natural gas) used in *IDAHO TAX-PAID gasoline used in
1. � Stationary engines 10. � Stationary engines
2. � UnregisteredX equipment(list) ____________________ 11. � Unregistered equipment (list) ________________
Tractor
3. � Refrigeration unit with separate tank 12. � Refrigeration unit with separate tank
4. � Intrastate motor vehicles off-highway miles (attach Form 75-IMV) 13. � IFTA auxiliary engine allowance (attach Form 75-IC)
5. � IFTA power take-off and auxiliary engine allowances 14. � Intrastate motor vehicle auxiliary engine
(attach Form 75-IC) allowance(attach Form 75-IMV)
6. � Intrastate motor vehicle power take-off and auxiliary engine 15. � X Aircraft (see instructions)
allowances (attach Form 75-IMV) 16. � Commercial motor boat
7. � Federal, state, and local government motor vehicles 17. � X Other (describe) ___________________________ATV
8. � Aircraft (see instructions)
9. � Other (describe) _______________________________ * Gasoline used in a registered motor vehicle (government or
privately owned) does not qualify for a refund of the gasoline tax.
Section IV. TOTAL REFUND OR TAX DUE
Complete the sections on page 2 that apply to you (Sections V, VI, or VII) before completing this section.
1. Gasoline tax refund from page 2, Section V, line 5 ....................................................................................... � $ 79
2. Special fuels tax refund from page 2, Section V, line 6 ................................................................................ � 75
3. Gasoline tax due from page 2, Section VI, line 4.......................................................................................... � 88
4. Special fuels tax due from page 2, Section VI, line 5 ................................................................................... �
5. Total of use tax due from page 2, Section VII, line 8 .................................................................................... � 56
I paid the use tax with my sales/use tax return. Permit number _____________________________
6. Refund. If the total of lines 1 and 2 is greater than the total of lines 3, 4, and 5,
enter the difference .................................................................................................................. � 10
7. Tax Due. If the total of lines 1 and 2 is less than the total of lines 3, 4, and 5,
enter the difference .................................................................................................................. �
Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct, and complete. See instructions.
Authorized signature Date Call 334-7660 in the Boise area or (800) 972-7660 toll free.
�SIGN MAIL TO:
HERE Title Daytimephone Idaho State Tax Commission
PO Box 76
Boise ID 83707-0076
Paid preparer's signature Preparer's EIN, SSN or PTIN
�
Address and phone number
|
|
EFO00055 07-03-08 Form 75 Page 2
AB** F C**DEG
Section V. FUELS TAX REFUND Gasoline Av Gas Jet Fuel Undyed Diesel* Propane Nat Gas Totals
1. Total tax-paid gallons purchased
from all sources (whole gallons) .... � 200 200 250 300
2. Total nontaxable gallons
(wholegallons)............................... � 200 200 250 300
3.Tax rate.......................................... .25 .07 .06 .25 .181 .197
4. Fuels tax refund ............................. 50 14 15 75
5. Gasoline tax refund. Add line 4, columns A, B & C. Enter here and on page 1, Section IV, line 1 ................................ 79
6. Special fuels tax refund. Add line 4, columns D, E & F. Enter here and on page 1, Section IV, line 2 .......................... 75
AB** F C**DEG
Section VI. FUELS TAX DUE Gasoline Av Gas Jet Fuel Undyed Diesel* Propane Nat Gas Totals
1. Taxable gallons
(wholegallons)............................... � 300 100 100
2.Tax rate.......................................... .25 .07 .06 .25 .181 .197
3. Fuels tax due ................................. 75 76
4. Gasoline tax due. Add line 3, columns A, B & C. Enter here and on page 1, Section IV, line 3 .................................. 88
5. Special fuels tax due. Add line 3, columns D, E & F. Enter here and on page 1, Section IV, line 4 .............................
AB** F C**DEG
Section VII. USE TAX DUE Gasoline Av Gas Jet Fuel Undyed Diesel* Propane Nat Gas Totals
1. Number of gallons from
200 200 250
Section V, line 2 ............................. �
2. Average price per gallon
(carry 4 decimal places x.xxxx)...... � 1.5000 1.7000 2.0000
3. Less state fuels tax/gallon ............. .25 .07 .06
4. Less federal fuels tax/gallon .......... � .184 .194 .219
5. The base cost per gallon
1.066 1.436 1.721
(line 2 less 3 & 4) ...........................
6. Total amount subject to use tax
213 287 430
(multiply line 1 by line 5) ................
7. Use tax due
(multiply line 6 by 6%).................... 13 17 26
8. Use tax due. Add line 7, columns A through F. Enter here and on page 1, Section IV, line 5 ......................................56
* Includes Biodiesel and Biodiesel Blends
** Rate change for Av Gas and Jet Fuel effective July 1, 2008.
|
|
F
O
R44 IDAHO BUSINESS INCOME TAX 2009
MEFO00006
06-10-09 CREDITS AND CREDIT RECAPTURE
Name(s) as shown on return Social Security Number or EIN
Dennis Cox 400-00-5952
PART I — BUSINESS INCOME TAX CREDITS
Credit Allowed Carryover
1. Investment tax credit. Attach Form 49 .................................................................. � 1 25 �10
2. Credit for production equipment using postconsumer waste................................. � 2 10 �5
3. Promoter sponsored event credit .......................................................................... � 3 5
4. Credit for qualifying new employees. Attach Form 55 .......................................... � 4 100 �25
5. Credit for Idaho research activities. Attach Form 67............................................. � 5 25 �10
6. Broadband equipment investment credit. Attach Form 68.................................... � 6 50 �35
7. Incentive investment tax credit. Attach Form 69 ................................................... � 7 75 �10
8. Small employer investment tax credit. Attach Form 83 ........................................ � 8 50 �25
9. Small employer real property improvement tax credit. Attach Form 84 ................ � 9 30 �20
10. Small employer new jobs tax credit. Attach Form 85............................................ � 10 15 �10
11. Biofuel infrastructure investment tax credit. Attach Form 71 ................................ � 11 �
12. Total business income tax credits allowed. Add lines 1 through 11 ...................... � 12 385
PART II — TAX FROM RECAPTURE OF INCOME TAX CREDITS
Tax from recapture of:
1. Investment tax credit. Attach Form 49R ................................................................................................ � 1 50
2. Broadband equipment investment credit. Attach Form 68R .................................................................. � 2 25
3. Small employer investment tax credit. Attach Form 83R ....................................................................... � 3
4. Small employer real property improvement tax credit. Attach Form 84R .............................................. � 4
5. Small employer new jobs tax credit. Attach Form 85R .......................................................................... � 5
6. Biofuel infrastructure investment tax credit. Attach Form 71R............................................................... � 6
7. Total tax from recapture of income tax credit. Add lines 1 through 6 ..................................................... � 7 75
|
|
F 8734
O
R EFO0008940 2009
M 08-21-09-v10
IDAHO INDIVIDUAL INCOME TAX RETURN
State Use Only
AMENDED RETURN, check the box. .
See instructions, page 6 for the reasons
for amending and enter the number. .
Your Social Security Number (required)
For calendar year 2009, or fiscal year beginning , ending
Your first name and initial Last name 400-00-5954
SAM V ADAMSON Spouse's Social Security Number (required)
Spouse's first name and initial Last name
400-00-5955
MARY N ADAMSON
TYPEMailing address Taxpayer deceased Do you need Idaho
� in 2009 income tax forms
1030 N MAIN ST
mailed to you next year?
City, State, and Zip Code Spouse deceased
PLEASE PRINT OR
POCATELLO ID 83202 � in 2009 . Yes . Nox
FILING STATUS. If filing married joint or separate return, enter spouse's name and Social Security number above.
1. Single 2. Married filing joint return 3. XMarried filing separate return 4. Head of household 5. Qualifying widow(er)
6. EXEMPTIONS. If someone can claim you as a Enter "1" in boxes 6a, Yourself a. 1 Election campaign fund
dependent, leave box 6a blank. and 6b, if they apply.
Spouse b. I want $1 of my income tax to go to the Idaho
Election Campaign Fund ($2 on joint return).
c. List your dependents. If more than four dependents, continue on Form 39R.
Enter the total number here ................................................................................ c.2 7. Yourself 8. Spouse 7. Yourself 8. Spouse
___________________________________________________________________ First name Last name Social Security Number
___________________________________________________________________ BOB ADAMSON 260 90 7080 Constitution Republican
. .
___________________________________________________________________ SALLY ADAMSON 123 45 6789 Democratic No Specific X X
. .
___________________________________________________________________ Libertarian None
. .
___________________________________________________________________
d. Total exemptions. Add lines 6a through 6c. Must match federal return ............ d. 3
INCOME. See instructions, page 7.
9. Enter your federal adjusted gross income from federal Form 1040, line 37; federal Form 1040A, line 21;
or federal Form 1040EZ, line 4. Attach a complete copy of your federal return ............................................ . 9 -1000 00
10. Additions from Form 39R, Part A, line 6. Attach Form 39R ........................................................................... 10 00
11. Total. Add lines 9 and 10 ................................................................................................................................ 11 00
12. Subtraction from Form 39R, Part B, line 23. Attach Form 39R ...................................................................... 12 00
13. TOTAL ADJUSTED INCOME. Subtract line 12 from line 11.
If you have an NOL and are electing to forego the carryback period, check here . ............................ 13 . -1000 00
TAX COMPUTATION. See instructions, page 7.
ATTACH PAYMENT HERE a. If age 65 or older ............................. .Yourself . Spouse
Standard 14. CHECK b. If blind ...............................................Yourself . Spouse
Deduction c. If your parent or someone else can claim you as a dependent,
For Most
People check here and enter zero on lines 20 and 46. .
Single or 15. Itemized deductions. Attach federal Schedule A. Federal limits apply ................................. . 15 00
Married filing 16. All state and local income or general sales taxes included on
Separately:
$5,700 federal Schedule A, line 5 ...................................................................................................... .16 00
Head of 17. Subtract line 16 from line 15. If you do not use federal Schedule A, enter zero ................... 17 00
Household:
$8,350 18. Standard deduction. See instructions page 7 to determine standard deduction amount
if different than the Standard Deduction For Most People ..................................................... . 18 5700 00
Married filing
Jointly or 19. Subtract the LARGER of line 17 or 18 from line 13. If less than zero, enter zero ................. 19 00
Qualifying
Widow(er): 20. Multiply $3,650 by the number of exemptions claimed on line 6d. Federal limits apply ....... . 20 10950 00
$11,400
ATTACH STATE W-2 COPIES HERE 21. Taxable income. Subtract line 20 from line 19. If less than zero, enter zero ....................... . 21 00
22. Tax from tables or rate schedule. See instructions, page 35 ................................................ . 22 00
Continue to page 2.
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise, ID 83756-0056
ATTACH A COMPLETE COPY OF YOUR FEDERAL RETURN. {¢S¦}
|
|
Form 40 - 2009 Page 2
EFO00089p2 08-31-09-v9
23. Tax amount from line 22 ............................................................................................................................................ 23 00
CREDITS. Limits apply. See instructions, page 8.
24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns . 24 00
25. Credit for contributions to Idaho educational entities ...................................................... . 25 00
26. Credit for contributions to Idaho youth and rehabilitation facilities .................................. . 26 00
27. Credit for live organ donation expenses ...........................................................................27 00
28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 ......... 28 00
29. TOTAL CREDITS. Add lines 24 through 28 ............................................................................................................. 29 00
30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero .................................................................. 30 00
OTHER TAXES. See instructions, page 9.
31. Fuels tax due. Attach Form 75 ................................................................................................................................. 31 00
32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases .............................................................. .32 00
33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 .................................. 33 00
34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER .................................................... .34 00
35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments .................. . 35 1000
36. TOTAL TAX. Add lines 30 through 35 ....................................................................................................................... . 36 0 00
DONATIONS. See instructions, page 9. I wish to donate to:
37. Nongame Wildlife Conservation Fund ........... .________ 38. Idaho Children's Trust Fund ............ ._________
39. Special Olympics Idaho ................................. .________ 40. Idaho Guard and Reserve Family ... ._________
41. American Red Cross of Greater Idaho Fund .. .________ 42. Veterans Support Fund ................... ._________
43. Idaho Foodbank ............................................ ________ .
44. Enter total donations. Add lines 37 through 43 ........................................................................................................ 44 00
45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................ 45 00
PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.
46. Grocery credit. Computed Amount (from worksheet) .................................................................. ______________. 180
To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46. . 180
To receive your grocery credit, enter the computed amount on line 46 .................................................................... .46 00
47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ............... . 47 00
48. Special fuels tax refund ________________ Gasoline tax refund ___________________ Attach Form 75 48 00
49. Idaho income tax withheld. Attach Form(s) W-2 ...................................................................................................... .49 200 00
50. 2009 Form 51 payment(s) and amount applied from 2008 return ............................................................................. .50 00
51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 .................................................................... 51 380 00
TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.
52. TAX DUE. Subtract line 51 from line 45 ......................................................................................................... .
00
53. Penalty ____________ Interest from the due date ____________ Enter total ..............................................
. . 53 00
Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account .................... .
54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ...... . 54 00
55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid ....................................................... .55 380 00
56. REFUND. Amount of line 55 to be refunded to you ....................................................................................... . 380
00
57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ...................................................... .57 00
58. DIRECT DEPOSIT. See instructions, page 12. . Check if final deposit destination is outside the U.S. Type of . Checking
X
. Routing No.3 2 4 17362 5 . Account No. 2 2 345 6789 1 0 1 1 121 3 Account:
. Savings
AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.
59. Total due (line 54) or overpaid (line 55) on this return ............................................................................................... 59 00
60. Refund from original return plus additional refunds ................................................................................................... 60 00
61. Tax paid with original return plus additional tax paid ................................................................................................. 61 00
62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 .................................................................... 62 00
. Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
SIGN Your signature Spouse's signature (if a joint return, BOTH MUST SIGN)
HERE . .
Date Daytime phone Preparer's EIN, SSN, or PTIN
.
Paid preparer's signature Address and phone number
. {¢U¦}
|
|
F 8734
O
R EFO0008940 2009
M 08-21-09-v10
IDAHO INDIVIDUAL INCOME TAX RETURN
State Use Only
AMENDED RETURN, check the box. .
X
See instructions, page 6 for the reasons
for amending and enter the number. . 4
Your Social Security Number (required)
For calendar year 2009, or fiscal year beginning , ending
Your first name and initial Last name 400-00-5956
TED M NORRIS Spouse's Social Security Number (required)
Spouse's first name and initial Last name
TYPEMailing address Taxpayer deceased Do you need Idaho
X � in 2009 income tax forms
13 Winners Circle Dr
mailed to you next year?
City, State, and Zip Code Spouse deceased
PLEASE PRINT OR
Horseshoe Bend ID 83626 � in 2009 . Yes . NoX
FILING STATUS. If filing married joint or separate return, enter spouse's name and Social Security number above.
1. Single 2. Married filing joint return 3. Married filing separate return 4. XHead of household 5. Qualifying widow(er)
6. EXEMPTIONS. If someone can claim you as a Enter "1" in boxes 6a, Yourself a. 1 Election campaign fund
dependent, leave box 6a blank. and 6b, if they apply.
Spouse b. I want $1 of my income tax to go to the Idaho
Election Campaign Fund ($2 on joint return).
c. List your dependents. If more than four dependents, continue on Form 39R.
Enter the total number here ................................................................................ c.2 7. Yourself 8. Spouse 7. Yourself 8. Spouse
___________________________________________________________________ First name Last name Social Security Number
___________________________________________________________________ John Norris 400 00 5970 Constitution RepublicanX
. .
___________________________________________________________________ Sam Norris 400 00 5971 Democratic No Specific
. .
___________________________________________________________________ Libertarian None
. .
___________________________________________________________________
d. Total exemptions. Add lines 6a through 6c. Must match federal return ............ d. 3
INCOME. See instructions, page 7.
9. Enter your federal adjusted gross income from federal Form 1040, line 37; federal Form 1040A, line 21;
or federal Form 1040EZ, line 4. Attach a complete copy of your federal return ............................................ . 9 26126 00
10. Additions from Form 39R, Part A, line 6. Attach Form 39R ........................................................................... 10 00
11. Total. Add lines 9 and 10 ................................................................................................................................ 11 26126 00
12. Subtraction from Form 39R, Part B, line 23. Attach Form 39R ...................................................................... 12 00
13. TOTAL ADJUSTED INCOME. Subtract line 12 from line 11.
If you have an NOL and are electing to forego the carryback period, check here . ............................ 13 . 26126 00
TAX COMPUTATION. See instructions, page 7.
ATTACH PAYMENT HERE a. If age 65 or older ............................. .Yourself . Spouse
Standard 14. CHECK b. If blind ...............................................Yourself . Spouse
Deduction c. If your parent or someone else can claim you as a dependent,
For Most
People check here and enter zero on lines 20 and 46. .
Single or 15. Itemized deductions. Attach federal Schedule A. Federal limits apply ................................. . 15 00
Married filing 16. All state and local income or general sales taxes included on
Separately:
$5,700 federal Schedule A, line 5 ...................................................................................................... .16 00
Head of 17. Subtract line 16 from line 15. If you do not use federal Schedule A, enter zero ................... 17 00
Household:
$8,350 18. Standard deduction. See instructions page 7 to determine standard deduction amount
if different than the Standard Deduction For Most People ..................................................... . 18 8350 00
Married filing
Jointly or 19. Subtract the LARGER of line 17 or 18 from line 13. If less than zero, enter zero ................. 19 17776 00
Qualifying
Widow(er): 20. Multiply $3,650 by the number of exemptions claimed on line 6d. Federal limits apply ....... . 20 10950 00
$11,400
ATTACH STATE W-2 COPIES HERE 21. Taxable income. Subtract line 20 from line 19. If less than zero, enter zero ....................... . 21 6826 00
22. Tax from tables or rate schedule. See instructions, page 35 ................................................ . 22 201 00
Continue to page 2.
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise, ID 83756-0056
ATTACH A COMPLETE COPY OF YOUR FEDERAL RETURN. {¢S¦}
|
|
Form 40 - 2009 Page 2
EFO00089p2 08-31-09-v9
23. Tax amount from line 22 ............................................................................................................................................ 23 201 00
CREDITS. Limits apply. See instructions, page 8.
24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns . 24 00
25. Credit for contributions to Idaho educational entities ...................................................... . 25 00
26. Credit for contributions to Idaho youth and rehabilitation facilities .................................. . 26 00
27. Credit for live organ donation expenses ...........................................................................27 00
28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 ......... 28 00
29. TOTAL CREDITS. Add lines 24 through 28 ............................................................................................................. 29 00
30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero .................................................................. 30 201 00
OTHER TAXES. See instructions, page 9.
31. Fuels tax due. Attach Form 75 ................................................................................................................................. 31 00
32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases .............................................................. .32 00
33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 .................................. 33 00
34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER .................................................... .34 00
35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments .................. . X 35 1000
36. TOTAL TAX. Add lines 30 through 35 ....................................................................................................................... . 36 201 00
DONATIONS. See instructions, page 9. I wish to donate to:
37. Nongame Wildlife Conservation Fund ........... .________ 38. Idaho Children's Trust Fund ............ ._________
39. Special Olympics Idaho ................................. .________ 40. Idaho Guard and Reserve Family ... ._________
41. American Red Cross of Greater Idaho Fund .. .________ 42. Veterans Support Fund ................... ._________
43. Idaho Foodbank ............................................ ________ .
44. Enter total donations. Add lines 37 through 43 ........................................................................................................ 44 00
45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................ 45 00
PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.
46. Grocery credit. Computed Amount (from worksheet) .................................................................. ______________. 120
To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46. . 120
To receive your grocery credit, enter the computed amount on line 46 .................................................................... .46 00
47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ............... . 47 00
48. Special fuels tax refund ________________ Gasoline tax refund ___________________ Attach Form 75 48 00
49. Idaho income tax withheld. Attach Form(s) W-2 ...................................................................................................... .49 200 00
50. 2009 Form 51 payment(s) and amount applied from 2008 return ............................................................................. .50 00
51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 .................................................................... 51 320 00
TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.
52. TAX DUE. Subtract line 51 from line 45 ......................................................................................................... .
00
. . 53 00
53. Penalty ____________ Interest from the due date ____________ Enter total ..............................................
Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account .................... .
54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ...... . 54 00
55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid ....................................................... .55 119 00
56. REFUND. Amount of line 55 to be refunded to you ....................................................................................... .
119 00
57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ...................................................... .57 00
58. DIRECT DEPOSIT. See instructions, page 12. . Check if final deposit destination is outside the U.S. Type of . Checking
. Routing No.3 2 4 60612 3 . Account No. 9 8 765 4321 0 0 0 0 000 0 Account:
.XSavings
AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.
59. Total due (line 54) or overpaid (line 55) on this return ............................................................................................... 59 00
60. Refund from original return plus additional refunds ................................................................................................... 60 00
61. Tax paid with original return plus additional tax paid ................................................................................................. 61 00
62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 .................................................................... 62 00
. Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
SIGN Your signature Spouse's signature (if a joint return, BOTH MUST SIGN)
HERE . .
Date Daytime phone Preparer's EIN, SSN, or PTIN
.
Paid preparer's signature Address and phone number
. {¢U¦}
|
|
F 8734
O
R EFO0008940 2009
M 08-21-09-v10
IDAHO INDIVIDUAL INCOME TAX RETURN
State Use Only
AMENDED RETURN, check the box. .
See instructions, page 6 for the reasons
for amending and enter the number. .
Your Social Security Number (required)
For calendar year 2009, or fiscal year beginning , ending
Your first name and initial Last name 400-00-5957
CLINT SMITH Spouse's Social Security Number (required)
Spouse's first name and initial Last name
TYPEMailing address Taxpayer deceased Do you need Idaho
� in 2009 income tax forms
9100 LANSING ST
mailed to you next year?
City, State, and Zip Code Spouse deceased
PLEASE PRINT OR
MIDDLETON ID 83644 � in 2009 . Yes . Nox
FILING STATUS. If filing married joint or separate return, enter spouse's name and Social Security number above.
1. Single 2. Married filing joint return 3. Married filing separate return 4. Head of household 5. Qualifying widow(er)
6. EXEMPTIONS. If someone can claim you as a Enter "1" in boxes 6a, Yourself a. 1 Election campaign fund
dependent, leave box 6a blank. and 6b, if they apply.
Spouse b. I want $1 of my income tax to go to the Idaho
Election Campaign Fund ($2 on joint return).
c. List your dependents. If more than four dependents, continue on Form 39R.
Enter the total number here ................................................................................ c. 7. Yourself 8. Spouse 7. Yourself 8. Spouse
___________________________________________________________________ First name Last name Social Security Number
___________________________________________________________________ Constitution Republican
. .
___________________________________________________________________ Democratic No Specific
. .
___________________________________________________________________ Libertarian None
. X.
___________________________________________________________________
d. Total exemptions. Add lines 6a through 6c. Must match federal return ............ d. 1
INCOME. See instructions, page 7.
9. Enter your federal adjusted gross income from federal Form 1040, line 37; federal Form 1040A, line 21;
or federal Form 1040EZ, line 4. Attach a complete copy of your federal return ............................................ . 9 0 00
10. Additions from Form 39R, Part A, line 6. Attach Form 39R ........................................................................... 10 00
11. Total. Add lines 9 and 10 ................................................................................................................................ 11 00
12. Subtraction from Form 39R, Part B, line 23. Attach Form 39R ...................................................................... 12 00
13. TOTAL ADJUSTED INCOME. Subtract line 12 from line 11.
If you have an NOL and are electing to forego the carryback period, check here . ............................ 13 . 0 00
TAX COMPUTATION. See instructions, page 7.
ATTACH PAYMENT HERE a. If age 65 or older ............................. .Yourself . Spouse
Standard 14. CHECK b. If blind ...............................................Yourself . Spouse
Deduction c. If your parent or someone else can claim you as a dependent,
For Most
People check here and enter zero on lines 20 and 46. .
Single or 15. Itemized deductions. Attach federal Schedule A. Federal limits apply ................................. . 15 00
Married filing 16. All state and local income or general sales taxes included on
Separately:
$5,700 federal Schedule A, line 5 ...................................................................................................... .16 00
Head of 17. Subtract line 16 from line 15. If you do not use federal Schedule A, enter zero ................... 17 00
Household:
$8,350 18. Standard deduction. See instructions page 7 to determine standard deduction amount
if different than the Standard Deduction For Most People ..................................................... . 18 5700 00
Married filing
Jointly or 19. Subtract the LARGER of line 17 or 18 from line 13. If less than zero, enter zero ................. 19 00
Qualifying
Widow(er): 20. Multiply $3,650 by the number of exemptions claimed on line 6d. Federal limits apply ....... . 20 3650 00
$11,400
ATTACH STATE W-2 COPIES HERE 21. Taxable income. Subtract line 20 from line 19. If less than zero, enter zero ....................... . 21 00
22. Tax from tables or rate schedule. See instructions, page 35 ................................................ . 22 00
Continue to page 2.
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise, ID 83756-0056
ATTACH A COMPLETE COPY OF YOUR FEDERAL RETURN. {¢S¦}
|
|
Form 40 - 2009 Page 2
EFO00089p2 08-31-09-v9
23. Tax amount from line 22 ............................................................................................................................................ 23 00
CREDITS. Limits apply. See instructions, page 8.
24. Income tax paid to other states. Attach Form 39R and a copy of the other state returns . 24 00
25. Credit for contributions to Idaho educational entities ...................................................... . 25 00
26. Credit for contributions to Idaho youth and rehabilitation facilities .................................. . 26 00
27. Credit for live organ donation expenses ...........................................................................27 00
28. Total business income tax credits from Form 44, Part I, line 12. Attach Form 44 ......... 28 00
29. TOTAL CREDITS. Add lines 24 through 28 ............................................................................................................. 29 00
30. Subtract line 29 from line 23. If line 29 is more than line 23, enter zero .................................................................. 30 00
OTHER TAXES. See instructions, page 9.
31. Fuels tax due. Attach Form 75 ................................................................................................................................. 31 00
32. Sales/Use tax due on mail order, Internet, and other nontaxed purchases .............................................................. .32 00
33. Total tax from recapture of income tax credits from Form 44, Part II, line 7. Attach Form 44 .................................. 33 00
34. Tax from recapture of qualified investment exemption (QIE). Attach Form 49ER .................................................... .34 00
35. Permanent building fund. Check the box if you are receiving Idaho public assistance payments .................. . 35 1000
36. TOTAL TAX. Add lines 30 through 35 ....................................................................................................................... . 36 0 00
DONATIONS. See instructions, page 9. I wish to donate to:
37. Nongame Wildlife Conservation Fund ........... .________ 38. Idaho Children's Trust Fund ............ ._________
39. Special Olympics Idaho ................................. .________ 40. Idaho Guard and Reserve Family ... ._________
41. American Red Cross of Greater Idaho Fund .. .________ 42. Veterans Support Fund ................... ._________
43. Idaho Foodbank ............................................ ________ .
44. Enter total donations. Add lines 37 through 43 ........................................................................................................ 44 00
45. TOTAL TAX PLUS DONATIONS. Add lines 36 and 44 ............................................................................................ 45 00
PAYMENTS and OTHER CREDITS. Complete the grocery credit refund worksheet on page 10.
46. Grocery credit. Computed Amount (from worksheet) .................................................................. ______________. 60
To donate your grocery credit to the Cooperative Welfare Fund, check the box and enter zero on line 46. . 60
To receive your grocery credit, enter the computed amount on line 46 .................................................................... .46 00
47. Maintaining a home for family member age 65 or older, or developmentally disabled. Attach Form 39R ............... . 47 00
48. Special fuels tax refund ________________ Gasoline tax refund ___________________ Attach Form 75 48 00
49. Idaho income tax withheld. Attach Form(s) W-2 ...................................................................................................... .49 00
50. 2009 Form 51 payment(s) and amount applied from 2008 return ............................................................................. .50 00
51. TOTAL PAYMENTS AND OTHER CREDITS. Add lines 46 through 50 .................................................................... 51 60 00
TAX DUE or REFUND. See instructions, page 11. If line 45 is more than line 51, GO TO LINE 52. If line 45 is less than line 51 GO TO LINE 55.
52. TAX DUE. Subtract line 51 from line 45 ......................................................................................................... .
00
. . 53 00
53. Penalty ____________ Interest from the due date ____________ Enter total ..............................................
Check box if penalty is due to an ineligible withdrawal from an Idaho medical savings account .................... .
54. TOTAL DUE. Add lines 52 and 53. Make check or money order payable to the Idaho State Tax Commission ...... . 54 00
55. OVERPAID. Line 51 minus lines 45 and 53. This is the amount you overpaid ....................................................... .55 60 00
56. REFUND. Amount of line 55 to be refunded to you ....................................................................................... . 60
00
57. ESTIMATED TAX. Amount of line 55 to be applied to your 2010 estimated tax ...................................................... .57 00
58. DIRECT DEPOSIT. See instructions, page 12. . Check if final deposit destination is outside the U.S. Type of .Checking
. Routing No. . Account No. Account:
.Savings
AMENDED RETURN ONLY. Complete this section to determine your tax due or refund. See instructions.
59. Total due (line 54) or overpaid (line 55) on this return ............................................................................................... 59 00
60. Refund from original return plus additional refunds ................................................................................................... 60 00
61. Tax paid with original return plus additional tax paid ................................................................................................. 61 00
62. Amended tax due or refund. Add lines 59 and 60 and subtract line 61 .................................................................... 62 00
. Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
SIGN Your signature Spouse's signature (if a joint return, BOTH MUST SIGN)
HERE . .
Date Daytime phone Preparer's EIN, SSN, or PTIN
.
Paid preparer's signature Address and phone number
. {¢U¦}
|