Fillable Printable 2010 Form 40S, Oregon Individual Income Tax Return (Short Form), 150-101-044
Fillable Printable 2010 Form 40S, Oregon Individual Income Tax Return (Short Form), 150-101-044
2010 Form 40S, Oregon Individual Income Tax Return (Short Form), 150-101-044
8 Wages (enter in box 8a) + unemployment (enter in box 8b) + interest and dividends (enter in box 8c)
•
8a +
•
8b +
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8c =
TOTAL INCOME
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8
9 2010 federal tax liability ($0–$5,850; see instructions for the correct amount) .......
•
9
10 Standard deduction from the back of this form .........................................................
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10
11 Add lines 9 and 10 .........................................................................................................................................
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11
12 Oregon taxable income. Line 8 minus line 11. If line 11 is more than line 8, enter -0- ..................................
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12
13 Tax. See instructions, page 13. Enter tax from tax tables or charts here
......................................................
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13
14 Exemption credit. Multiply your total exemptions on line 6e by $177 .....................
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14
15 Child and dependent care credit. See instructions, page 13.....................................
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15
16 Other credits. Identify:
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16a
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16b
$
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16c
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16d
$
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16
17 Total non-refundable credits. Add lines 14 through 16 .................................................................................
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17
18 Net income tax. Line 13 minus line 17. If line 17 is more than line 13, enter -0-
...........................................
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18
19 Oregon income tax withheld. Include your Form(s) W-2 and 1099 ........................
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19
20 Earned income credit. See instructions, page 14 ......................................................
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20
21 Working family child care credit from WFC, line 18 ...............................................
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21
22 Mobile home park closure credit. Include Schedule MPC .........................................
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22
23 Total payments and refundable credits. Add lines 19 through 22 .................................................................
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23
24 Refund. If line 23 is more than line 18, you have a refund. Line 23 minus line 18 ................. REFUND
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24
25 Tax to pay. If line 18 is more than line 23, you have tax to pay. Line 18 minus line 23
.... TAX TO PAY
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25
Oregon Nongame Wildlife
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26 St. Vincent de Paul Society
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27
The Nature Conservancy
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28 Doernbecher Children’s Hospital
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29
Oregon Humane Society
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30 The Salvation Army
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31
Oregon Veterans’ Home
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32
Planned Parenthood of Oregon
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33
Oregon Lions Sight & Hearing
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34 Shriners Hospitals for Children
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35
Special Olympics Oregon
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36 Susan G. Komen for the Cure
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37
Charity code
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38a
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38b Charity code
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39a
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39b
40 Total. Add lines 26 through 39. Total can’t be more than your refund on line 24..........................................
•
40
41 NET REFUND. Line 24 minus line 40. This is your net refund .......................................NET REFUND
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• 41
42 For direct deposit of your refund, see instructions, page 30.
Will this refund go to an account outside the United States? • Yes
These will
reduce
your refund
Include
proof of
withholding
(W-2s,
1099s),
payment,
and payment
voucher
Round to the nearest dollar
Include Schedule
WFC if you claim
this credit
Signature of preparer other than taxpayerYour signature Date
Address Telephone No.
X
X
Spouse’s/RDP’s signature (if filing jointly, BOTH must sign) Date
X
•
License No.
Under penalty for false swearing, I declare that the information in this return is true, correct, and complete.
DIRECT
DEPOSIT
•
Routing No.
•
Account No.
•
Type of Account:
Checking or Savings
ADD TOGETHER
CHARITABLE
CHECKOFF
DONATIONS,
PAGE 14
I want to donate
part of my tax
refund to the
following fund(s)
7e
•
If there is a kicker refund,
I want to donate mine to the
State School Fund
Date of birth (mm/dd/yyyy)
Date of birth (mm/dd/yyyy)
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Last name First name and initial
Social Security No. (SSN)
– –
Spouse’s/RDP’s last name if joint return Spouse’s/RDP’s first name and initial if joint return Spouse’s/RDP’s SSN if joint return
– –
Telephone numberCurrent mailing address
City State ZIP code
If you filed a return last year, and your
name or address is different, check here
( )
Country
For office use only
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A K F P
Deceased
Deceased
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150-101-044 (Rev. 12-10)
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SHORT FORM
2010
Form
40S
FULL-YEAR RESIDENTS ONLY
OREGON
Individual Income Tax Return
Amended Return
•
1 Single
2a Married ling jointly
2b Registered domestic partners (RDP) ling jointly
3a Married ling separately:
Spouse’s name _____________________________ Spouse’s SSN ___________________
3b Registered domestic partner ling separately:
Partner’s name _____________________________ Partner’s SSN ___________________
4 Head of household: Person who qualies you ________________________________
5 Qualifying widow(er) with dependent child
Filing
Status
Check
only
one
box
Exemptions
6a
Yourself ...........Regular ......Severely disabled ....6a
6b Spouse/RDP ...Regular ......Severely disabled ......b
6c All dependents First names __________________________________
•
c
6d
Disabled First names __________________________________
•
d
children only
(see instructions)
Total
Total
6e
•
••
7d
•
Someone else
can claim you as
a dependent
7c
•
You have
federal Form 8886
7b
•
You
filed an
extension
Check
all that
apply
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7a
• •
You were: 65 or older Blind
Spouse/RDP was: 65 or older Blind
Clear Form
How to figure your standard deduction
• Standard deduction. Unless you are claimed as a dependent, or are age 65 or older, or blind, your
standard deduction is based on your filing status as follows:
Single .............................................................................................................. $1,950
Married/RDP filing jointly ............................................................................. 3,900
Married/RDP filing separately
If spouse/RDP claims standard deduction .............................................. 1,950
If spouse/RDP claims itemized deductions ............................................. -0-
Head of household ........................................................................................ 3,140
Qualifying widow(er) ..................................................................................... 3,900
• Standard deduction—Dependents. If you can be claimed as a dependent on another person’s return,
your standard deduction is limited to the larger of:
— Your earned income plus $300, up to the maximum allowed for your filing status, shown above, or
— $950.
This limit applies even if you can be, but are not, claimed as a dependent on another person’s return. See
the standard deduction worksheet for single dependents on page 13, or contact us if you are a married/RDP
dependent.
• Standard deduction—Age 65 or older, or blind. If you are age 65 or older, or blind, you are entitled to
a larger standard deduction based on your filing status:
1. Are you:
65 or older? Blind?
If claiming spouse’s/RDP’s exemption, is your spouse/RDP:
65 or older? Blind?
2.
• Standard deduction—Nonresident aliens. The standard deduction for nonresident aliens, as defined
by federal law, is -0-.
Page 2 — 2010 Form 40S
If you owe, make your check or money order payable to the Oregon Department of Revenue.
Write your daytime telephone number and “2010 Oregon Form 40S” on your check or money order.
Include your payment, along with the payment voucher on page 29, with this return.
If your And the number Then your
filing of boxes checked standard
status is... in step 1 above is... deduction is...
Single
1 $3,150
2 4,350
Married/RDP
1 4,900
filing
2 5,900
jointly
3 6,900
4 7,900
If your And the number Then your
filing of boxes checked standard
status is... in step 1 above is... deduction is...
Married/RDP
1 $2,950
filing
2 3,950
separately
3 4,950
4 5,950
Head of 1 4,340
household 2 5,540
Qualifying 1 4,900
widow(er) 2 5,900
Oregon Department of Revenue
PO Box 14555
Salem OR 97309-0940
Mail REFUND returns
and NO-TAX-DUE
returns to
Mail
TAX-TO-PAY
returns to
REFUND
PO Box 14700
Salem OR 97309-0930
150-101-044 (Rev. 12-10)
