740-NP |
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KENTUCKY INCOM E TAX RETURN |
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42A740-S9 |
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NONRESIDENT OR PART-YEAR RESIDENT |
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Departm ent of Revenue |
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¸ Check if Amended Return |
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2004 |
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For calendar year or other taxable year beginning _______________ , 2004, and ending _______________ , 2005 . |
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Nam e—Last, First, M iddle Initial (Joint return, give both nam es and initials.) |
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Your Social Security Num ber |
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Use |
➤ |
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B. |
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L |
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Kentucky |
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A |
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M ailing Address (Num ber and Street Including Apartm ent Num ber or P.O. Box) |
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Spouse's Social Security Num ber |
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label if |
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correct. |
B |
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A. |
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Otherw ise |
E |
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print or |
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City, Tow n or Post Office |
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State |
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ZIP Code |
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POLITICAL PARTY FUND |
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type. |
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➤ |
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Designating $2 w ill not change your refund |
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or tax due. |
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1 |
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Single |
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✔ |
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FILING |
2 |
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M arried, filing joint return. |
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A. Spouse |
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B. Yourself |
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3 |
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M arried, filing separate returns. Enter spouse's Social Security |
Democratic |
(1) |
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(4) |
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(see |
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num ber above and full nam e here. |
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Republican |
(2) |
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(5) |
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instructions) |
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No Designation |
(3) |
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(6) |
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✔ |
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✔ |
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CREDITS |
COM PLETE PAGE 2 OF THIS FORM BEFORE COM PLETING LINES 4 THROUGH 31. |
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OFFICIAL USE ONLY |
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4 |
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Enter total tax credits claim ed on page 2, line 35 |
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➤ |
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1 |
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2 |
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4 |
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5 |
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Enter am ount from page 2, line 62, Colum n A. This is your federal Adjusted Gross Income |
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00 |
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Enter am ount from page 2, line 62, Colum n B. This is your Kentucky Adjusted Gross Income |
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TAXABLE |
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Nonitemizers: Enter $1,870. Skip lines 8(a) and 8(b) (do not prorate) |
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7 |
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00 |
INCOM E |
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(a) |
Itemizers: Enter item ized deductions from Kentucky Schedule A, |
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Form 740-NP |
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8(a) |
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00 |
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(b) |
M ultiply line 8(a) by the percentage ( |
%) |
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from page 2, line 63 |
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8(b) |
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9 |
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Subtract line 7 or line 8(b) from line 6. This is your Taxable Income |
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9 |
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TAX |
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Enter tax from Form 740-NP Tax Table |
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10 |
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M ultiply $20 by num ber of tax credits claim ed (from line 4) |
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11 |
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00 |
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12 |
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M ultiply line 11 by the percentage ( |
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%) from page 2, line 63 |
12 |
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00 |
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13 |
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Other tax credits (see instructions) |
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13 |
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00 |
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14 |
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Subtract lines 12 and 13 from line 10 |
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14 |
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00 |
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15 |
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Enter Low Income Credit from w orksheet in the instructions |
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15 |
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16 |
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Subtract line 15 from line 14 |
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16 |
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00 |
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Enter Child and Dependent Care Credit from w orksheet in the instructions |
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17 |
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18 |
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Subtract line 17 from line 16. This is your Income Tax Liability |
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18 |
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00 |
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19 |
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Enter KENTUCKY USE TAX from w orksheet in the instructions |
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➤ 19 |
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00 |
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20 |
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Add lines 18 and 19. This is your Total Tax Liability |
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20 |
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00 |
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21 |
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(a) |
Enter Kentucky income tax w ithheld as show n |
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on attached 2004 Form W-2, Wage and Tax Statem ent(s) |
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21(a) |
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00 |
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(b) |
Enter 2004 Kentucky estim ated tax paym ents |
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21(b) |
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00 |
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22 |
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Add lines 21(a) and 21(b) |
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22 |
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00 |
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23 |
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.................................If line 22 is larger than line 20, enter AM OUNT OVERPAID (see instructions) |
23 |
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00 |
See |
24 Nature and Wildlife Fund Contribution |
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¸ $2 |
¸ $5 |
¸ $10 ¸ Other |
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Enter am ount checked |
24 |
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00 |
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instruc- |
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tions for a |
25 |
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Child Victims’ Trust Fund Contribution |
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detailed |
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¸ $2 |
¸ $4 |
¸ Other |
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Enter am ount checked |
25 |
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00 |
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description |
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26 |
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Bluegrass State Games and U.S. Olympic Committee Fund Contribution |
26 |
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00 |
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of funds. |
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27 |
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Veterans’ Program Trust Fund Contribution |
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27 |
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00 |
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28 |
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Add lines 24 through 27 |
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28 |
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00 |
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29 |
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..............Am ount of line 23 to be CREDITED to your 2005 estim ated tax |
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ESTIM ATED TAX |
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29 |
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00 |
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30 |
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Subtract lines 28 and 29 from line 23. Am ount to be REFUNDED TO YOU |
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REFUND |
30 |
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00 |