*1911014A*
Your Signature Date Daytime Telephone Number Your Occupation
Spouse’s Signature (if joint return, BOTH must sign) Date Daytime Telephone Number Spouse’s Occupation
Preparer’s Signature Date Check if Self-employed Preparer’s SSN or PTIN E.I. Number
Firms’s Name (or yours Daytime ZIP
if self employed) Telephone No. Code
Address
ADOR
B — IncomeA — Alabama tax withheld
Deductions
AMOUNT
YOU OWE
OVERPAID
Donations
REFUND
Filing Status/
Exemptions
Income
and
Adjustments
Tax and
Payments
Staple Form(s)
W-2, W-2G,
and/or 1099 here.
Attach Schedule
W-2 to return.
CHECK BOX IF AMENDED RETURN •
FORM
40A Alabama 2019
Individual Income Tax Return
FULL YEAR RESIDENTS ONLY
For the year Jan. 1 - Dec. 31, 2019, or other tax year:
Beginning: Ending:
•
Your social security number Spouse’s SSN if joint return
• •
•
Check if primary is deceased
•
Check if spouse is deceased
Primary’s deceased date Spouse’s deceased date
(mm/dd/yy)
•
(mm/dd/yy)
•
Your first name Initial Last name
• • •
Spouse’s first name Initial Last name
• • •
Present home address (number and street or P.O. Box number)
•
City, town or post office State ZIP code
Check if address
Foreign Country
• • • •
is outside U.S.
•
$1,500 Single 3
•
$1,500 Married filing separate. Complete Spouse SSN
•
•
$3,000 Married filing joint 4
•
$3,000 Head of Family (with qualifying person).
Alabama Income Tax Withheld
(from Schedule W-2, line 18, column G)
...........
Wages, salaries, tips, etc.
(from Schedule W-2, line 18, column I plus J)...........
Interest and dividend income. If over $1,500.00, use Form 40 .......................................................
Total income. Add lines 5b and 6
(column B)
.....................................................................
Standard Deduction
(enter amount from table on page 9 of instructions)
..........
Federal tax deduction
(see instructions)
......................................
DO NOT ENTER THE FEDERAL TAX WITHHELD FROM YOUR FORM W-2(S)
Personal exemption
(from line 1, 2, 3, or 4)
....................................
Dependent exemptions
(from page 2, Part II, line 2)
............................
Total deductions. Add lines 8, 9, 10, and 11 .....................................................................
Taxable income. Subtract line 12 from line 7. Enter the result ......................................................
Find the tax for the amount on line 13. Use the tax table in the Instruction Booklet .....................................
Consumer Use Tax (see instructions). If you certify that no use tax is due, check box
............................
You may make a voluntary contribution to: a Alabama Democratic Party .........
$1
$2
none ......
b Alabama Republican Party .........
$1
$2
none ......
Total tax liability and voluntary contribution. Add lines 14, 15, 16a, and 16b .......................................
Alabama income tax withheld
(from column A, line 5a)
...........................................................
Automatic Extension Payment ..................................................................................
Amended Returns Only — Previous payments
(see instructions)
....................................................
Total payments. Add lines 18, 19 and 20 ........................................................................
Amended Returns Only – Previous refund (see instructions) ........................................................
Adjusted Total Payments. Subtract line 22 from line 21 ...........................................................
If line 17 is larger than line 23, subtract line 23 from line 17, and enter AMOUNT YOU OWE.
Place payment, along with Form 40V, loose in the mailing envelope. (FORM 40V MUST ACCOMPANY PAYMENT.) .......
If line 23 is larger than line 17, subtract line 17 from line 23 and enter amount OVERPAID ..............................
Total Donation Check-offs from page 2, Part IV, line 2. .............................................................
REFUNDED TO YOU. Subtract line 26 from line 25.
(You MUST SIGN this return before your refund can be processed.) .................................................
Sign Here
In Black Ink
Keep a copy
of this return
for your
records.
Paid
Preparer’s
Use Only
•
I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and com-
plete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
•
If claiming a deduc-
tion on line 9, you
must attach page
1,2 and Schedule 1
of your Federal Re-
turn, if applicable.
•
5b
6
7
12
13
14
15
16a
16b
17
18
19
20
21
22
23
24
25
26
27
1
2
5a
5b
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
8
9
10
11
5a
•
•
•
•
•
•
•
•
•
•
•
•
•
•
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•
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