Fillable Printable Iowa Individual Income Tax Form 2007
Fillable Printable Iowa Individual Income Tax Form 2007
Iowa Individual Income Tax Form 2007
1. Wages, salaries, tips, etc. ................................................................. 1. ______________ .00 ______________ .00
2. Taxable interest income. If more than $1,500, complete Sch. B. ...... 2. ______________ .00 ______________ .00
3. Ordinary dividend income. If more than $1,500, complete Sch. B. ...... 3. ______________ .00 ______________ .00
4. Alimony received .............................................................................. 4. ______________ .00 ______________ .00
5. Business income/(loss) from federal Schedule C or C-EZ .............. 5. ______________ .00 ______________ .00
6. Capital gain/(loss) from federal Sch. D if required for federal purposes . 6. ______________ .00 ______________ .00
7. Other gains/(losses) from federal form 4797 .................................... 7. ______________ .00 ______________ .00
8. Taxable IRA distributions .................................................................. 8. ______________ .00 ______________ .00
9. Taxable pensions and annuities ....................................................... 9. ______________ .00 ______________ .00
10. Rents, royalties, partnerships, estates, etc. ..................................... 10. ______________ .00 ______________ .00
11. Farm income/(loss) from federal Schedule F ................................... 11. ______________ .00 ______________ .00
12. Unemployment compensation. See instructions. ............................. 12. ______________ .00 ______________ .00
13. Taxable Social Security benefits ...................................................... 13. ______________ .00 s ______________ .00
14. Other income, gambling income, bonus depreciation/section 179 adjustment ... 14. ______________ .00 ______________ .00
15. GROSS INCOME. ADD lines 1-14. ........................................................................................................................... 15. _______________ .00 s _______________ .00
16. Payments to an IRA, Keogh, or SEP ............................................... 16. ______________ .00 ______________ .00
17. Deductible part of self-employment tax ............................................ 17. ______________ .00 ______________ .00
18. Health insurance deduction .............................................................. 18. ______________ .00 ______________ .00
19. Penalty on early withdrawal of savings ............................................ 19. ______________ .00 ______________ .00
20. Alimony paid ..................................................................................... 20. ______________ .00 ______________ .00
21. Pension/retirement income exclusion .............................................. 21. ______________ .00 s ______________ .00
22. Moving expense deduction from federal form 3903 ......................... 22. ______________ .00 ______________ .00
23. Iowa capital gain deduction certain asset sales ONLY (see instructions).23. ______________ .00 s ______________ .00
24. Other adjustments ............................................................................ 24. ______________ .00 ______________ .00
25. Total adjustments. ADD lines 16-24. ........................................................................................................................ 25. _______________ .00 s _______________ .00
26. NET INCOME. SUBTRACT line 25 from line 15. .................................................................................................... 26. _______________ .00 s _______________ .00
27. Federal income tax refund / overpayment received in 2011 ............ 27. ______________ .00 s ______________ .00
28. Self-employment/household employment taxes .............................. 28. ______________ .00 s ______________ .00
29. Addition for federal taxes. ADD lines 27 and 28. ...................................................................................................... 29. _______________ .00 _______________ .00
30. Total. ADD lines 26 and 29. ...................................................................................................................................... 30. _______________ .00 _______________ .00
31. Federal tax withheld ......................................................................... 31. ______________ .00 s ______________ .00
32. Federal estimated tax payments made in 2011 ............................... 32. ______________ .00 s ______________ .00
33. Additional federal tax paid in 2011 for 2010 and prior years ........... 33. ______________ .00 s ______________ .00
34. Deduction for federal taxes. ADD lines 31, 32, and 33. ............................................................................................ 34. _______________ .00 _______________ .00
35. BALANCE. SUBTRACT line 34 from line 30. Enter here and on line 36, side 2. .................................................... 35. _______________ .00 _______________ .00
B. Spouse (Filing Status 3 ONLY) A. You or Joint
a. Personal Credit: Col. A: Enter 1 (enter 2 if filing status 2 or 5); Col. B: Enter 1 if filing status 3
b. Enter 1 for each person who is 65 or older and/or 1 for each person who is blind..............
c. Dependents: Enter 1 for each dependent ...................................................................
d. Enter first names of dependents here: ____________________________________
s
STEP 6
Federal
Tax
Addition
and
Deduc-
tion
STEP 4
Gross
Income
STEP 5
Adjust-
ments
to
Income
41-001a (09/21/11)
2011 IA 1040 Iowa Individual Income Tax Form
or fiscal year beginning __/__ 2011 and ending __/__ /__
Spouse SSN
•
Your SSN
•
STEP 3 Exemptions
e. TOTAL $
$
s
s
STEP 1: Fill in all spaces. You MUST fill in your Social Security Number (SSN).
Your last name Your first name/middle initial
Spouse’s last name Spouse’s first name/middle initial
Current mailing address (number and street, apartment, lot, or suite number) or PO Box
City, State, ZIP
X $ 20 = $ X $ 20 = $
B. Spouse/Status 3 A. You or Joint B. Spouse/Status 3 A. You or Joint
s
s
X $ 40 = $ X $ 40 = $
s
STEP 2 Filing Status: Mark one box only.
1 Single: Were you claimed as a dependent on another person’s Iowa return? YES NO
2 Married filing a joint return. (Two-income families may benefit by using status 3 or 4.)
3 Married filing separately on this combined return. Spouse use column B.
4 Married filing separate returns. Spouse’s name: SSN: Income: $
5 Head of household with qualifying person. If qualifying person is not claimed as a dependent on this return, enter the person’s name and SSN below.
How many do not have health care coverage?
•
Check this box if you or your spouse were 65 or older as of 12/31/11.
How many have health care coverage?(including Medicaid or hawk-i)
•
Dependent children for whom an exemption is claimed in Step 3
Residence on 12/31/11
County Number
•
School District Number
•
6 Qualifying widow(er) with dependent child. Name: SSN:
X $ 40 = $
X $ 40 = $
s
s
NOTE: Use only
blue or black ink,
no pencils or red ink.
Ü
Enclose W-2s and payment with your return - DO NOT STAPLE them here.
Û
•
s
*1141001019999*
Print Form
Reset Form
B. Spouse/Status 3 A. You or Joint B. Spouse/Status 3 A. You or Joint
36. BALANCE. From side 1, line 35 ................................................................................................................................ 36. _______________ .00 _______________ .00
37. Total itemized deductions from federal Schedule A ................. 37. ______________ .00 ______________ .00
Taxpayers with bonus depreciation/section 179 must use Iowa Schedule A.
38. Iowa income tax if included in line 5 of federal Schedule A ..... 38. ______________ .00 ______________ .00
39. BALANCE. Subtract line 38 from line 37 or enter the .............. 39. ______________ .00 ______________ .00
amount of itemized deductions from the Iowa Schedule A.
40. Other deductions ....................................................................... 40. ______________ .00 ______________ .00
41. Deduction. Check one box. Itemized. Add lines 39 and 40. Standard ................................................... 41. _______________ .00 s _______________ .00
42. TAXABLE INCOME. SUBTRACT line 41 from line 36. ........................................................................................... 42. _______________ .00 _______________ .00
43. Tax from tables or alternate tax ....................................................... 43. ______________ .00 s ______________ .00
44. Iowa lump-sum tax. 25% of federal tax from form 4972 .................. 44. ______________ .00 s ______________ .00
45. Iowa minimum tax. Attach IA 6251. ................................................. 45. ______________ .00 s ______________ .00
46. Total tax. ADD lines 43, 44, and 45. ......................................................................................................................... 46. _______________ .00 _______________ .00
47. Total exemption credit amount(s) from Step 3, side 1 ..................... 47. ______________ .00 ______________ .00
48. Tuition and textbook credit for dependents K-12 ............................. 48. ______________ .00 s ______________ .00
49. Total credits. ADD lines 47 and 48. ........................................................................................................................... 49. _______________ .00 _______________ .00
50. BALANCE. SUBTRACT line 49 from line 46. If less than zero, enter zero. ............................................................. 50. _______________ .00 s _______________ .00
51. Credit for nonresident or part-year resident. Attach IA 126 and federal return. ....................................................... 51. _______________ .00 s _______________ .00
52. BALANCE. SUBTRACT line 51 from 50. If less than or equal to zero, enter zero. ................................................. 52. _______________ .00 _______________ .00
53. Other nonrefundable Iowa credits. Attach IA 148 Tax Credits Schedule. ................................................................ 53. _______________ .00 s _______________ .00
54. BALANCE. SUBTRACT line 53 from line 52. ........................................................................................................... 54. _______________ .00 _______________ .00
55. School district surtax/EMS surtax. Take percentage from table; multiply by line 54. .............................................. 55. _______________ .00 s _______________ .00
56. Total Tax. ADD lines 54 and 55. ............................................................................................................................... 56. _______________ .00 s _______________ .00
57. Total tax before contributions. ADD columns A & B on line 56 and enter here. ............................................................................................ 57. _______________ .00
58. Contributions. Contributions will reduce your refund or add to the amount you owe. Amounts must be in whole dollars.
Fish/Wildlife 58a: s StateFair 58b: s Firefighters/Veterans 58c: Child Abuse Prevention 58d: Enter total. . 58. _______________ .00
59. TOTAL TAX AND CONTRIBUTIONS. ADD lines 57 and 58. ........................................................................................................................ 59. _______________ .00
60. Iowa income tax withheld ................................................................. 60. ______________ .00 s ______________ .00
61. Estimated and voucher payments made for tax year 2011 ............. 61. ______________ .00 s ______________ .00
62. Out-of-state tax credit. Attach IA 130. .............................................. 62. ______________ .00 s ______________ .00
63. Motor fuel tax credit. Attach IA 4136. ............................................... 63. ______________ .00 s ______________ .00
64. Check One: Child and dependent care credit OR
Early childhood development credit ...................... 64. ______________ .00 s ______________ .00
65. Iowa earned income tax credit. See Instructions. .......................... 65. ______________ .00 s ______________ .00
66. Other refundable credits. Attach IA 148 Tax Credits Schedule. ...... 66. ______________ .00 s ______________ .00
67. TOTAL. ADD lines 60 - 66. ............................................................... 67. ______________ .00 ______________ .00
68. TOTAL CREDITS. ADD columns A and B on line 67 and enter here. ........................................................................................................... 68. _______________ .00
69. If line 68 is more than line 59, SUBTRACT line 59 from line 68. This is the amount you overpaid. .............................................................. 69. s _______________ .00
70. Amount of line 69 to be REFUNDED ........................................................................................................................................... REFUND 70. s _______________ .00
For a faster refund file electronically. Go to www.iowa.gov/tax for details or mail return to
Iowa Income Tax - Refund Processing, Hoover State Office Bldg, Des Moines IA 50319-0120
71. Amount of line 69 to be applied to your 2012 estimated tax ....... 71. ______________ .00 s ______________ .00
72. If line 68 is less than line 59, SUBTRACT line 68 from line 59. This is the AMOUNT OF TAX YOU OWE. ................................................. 72. s _______________ .00
73. Penalty for underpayment of estimated tax from IA 2210 or IA 2210F
Check if annualized income method is used. ..................... 73. s _______________ .00
74. Penalty and interest ............................ 74a. Penalty ______________ .00 s 74b. Interest _______________ .00 s ADD Enter total 74. _______________ .00
75. TOTAL AMOUNT DUE. ADD lines 72, 73, and 74, and enter here. ........................................................................ PAY THIS AMOUNT 75. s _______________ .00
You can pay online at www.iowa.gov/tax or pay by mail to Iowa Income Tax - Document Processing,
PO Box 9187, Des Moines IA 50306-9187. Make check payable to Treasurer, State of Iowa.
Complete lines 37-40
ONLY if you itemize.
}
STEP 7
Taxable
Income
STEP 8
Tax,
Credits
and
Checkoff
Contribu-
tions
STEP 9
Credits
STEP 10
Refund
or
Amount
You Owe
2011 IA 1040, page 2
This return is due April 30, 2012. Please sign, enclose W-2s, and verify SSNs.
MAILING ADDRESSES: See lines 70 and 75 above.
$1.50 to Democratic Party
$1.50 to Republican Party
$1.50 to Campaign Fund
$1.50 to Democratic Party
$1.50 to Republican Party
$1.50 to Campaign Fund
Daytime Telephone Number Daytime Telephone Number
s s
STEP 12 I (We), the undersigned, declare under penalty of perjury that I (we) have examined this return, including all accompanying schedules
and statements, and, to the best of my (our) knowledge and belief, it is a true, correct, and complete return. Declaration of preparer
(other than taxpayer) is based on all information of which the preparer has any knowledge.
Your Signature Date Check if Deceased Date of Death
Spouse’s Signature Date Check if Deceased Date of Death
POLITICAL CHECKOFF. This checkoff does not increase the
amount of tax you owe or decrease your refund.
STEP 11
41-001b (09/21/11)
SPOUSE: YOURSELF:
Preparer’s Signature Date
Preparer’s SSN,FEIN, or PTIN
PLEASE
SIGN HERE
SIGN HERE
s
s
s
s
s
s
s
*1141001029999*
