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IA1040 2019 02UF PR IA1040_2019

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41-001 (09/10/19)
2019 IA 1040 Iowa Individual Income Tax Return
For fiscal year beginning ________/________/________ and ending ________/________/_________
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:
Spouse SSN:
Your SSN:
Step 2 Filing Status: Mark one box only
1
Single: Were you claimed as a dependent on another person’s Iowa return?
Yes No Email Address:
2
Married filing a joint return. (Two
-income families may benefit by using status 3 or 4.) Check this box if you or your spouse was 65 or older as of 12/31/19.
3
Married filing separately on this combined return. Spouse use column B.
Residence on 12/31/19: County No.
School District
No.
4
. Spouse's name:
▲SSN:
Net 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.
6
Qualifying
widow(er) with dependent child.
Name:
SSN:
Step 3 Exemptions
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 .
...........
▲
X $ 40 =
$
▲
X $ 40 =
$
b.
Enter 1 for each taxpayer who is 65 or older and/or 1 for each taxpayer who is blind.
..........................
▲
X $ 20 =
$
▲
X $ 20 =
$
c.
Dependents: Enter 1 for each dependent. ................................................................
.............................
▲
X $ 40 =
$
▲
X $ 40 =
$
d.
Enter first names of dependents here e. Total
$ _____________
e. Total
$ ____________
Step 4 Reportable Social Security Benefits as calculated on line 11 of Iowa social security worksheet
B. Spouse/Status 3 ▲ A. You or Joint ▲
B. Spouse/Status 3
A. You or Joint
B. Spouse/Status 3
A. You or Joint
Step 5
Gross
Income
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). See instructions ................................
..............
5.
.00
.00
NOTE: Use only
blue or black
ink, no pencils
or red ink.
6.
Capital gain/(loss). See instructions ................................
......................
6.
.00
.00
7.
Other gains/(losses). See instructions ................................
...................
7.
.00
.00
8.
Taxable IRA distributions ................................................................
.......
8.
.00
.00
9.
Taxable pensions and annuities ................................
............................
9.
.00
.00
10.
Rents, royalties, partnerships, estates, etc. See instructions
...............
10.
.00
.00
11.
Farm income/(loss). See instructions ................................
....................
11.
.00
.00
12.
Unemployment compensation. See instructions ................................
...
12.
.00
.00
13.
Gambling winnings ................................................................
................
13.
.00
.00
14.
Other income, bonus depreciation, and section 179 adjustment
.........
14.
.00
.00
15.
Gross Income
. Add lines 1-14 ................................................................................................................................
......
15.
__________________
.00
▲
________________
.00
Step 6
Adjust
-
ments to
Income
16.
Payments to an IRA, Keogh, or SEP ................................
.....................
16.
.00
.00
17.
Deductible part of self-employment tax. ................................
................
17.
.00
.00
18.
Health insurance premium ................................................................
.....
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
▲
.00
22.
Moving expense deduction from federal form 3903
..............................
22.
.00
.00
23.
Iowa capital gain deduction; Include corresponding IA 100
schedule .................................................................................................
23.
.00
▲
.00
24.
Other adjustments ................................................................
.................
24.
.00
.00
25.
Total adjustments. Add lines 16-24 ................................................................................................
.............................
25.
.00
▲
.00
26.
Net Income. Subtract line 25 from line 15
................................................................................................
....................
26.
____________________
.00
▲
________________
.00
Step 7
Federal
Tax
es
and
Qualified
Deduc
-
tions
27.
Federal income tax refund/overpayment received in 2019
...................
27.
.00
▲
.00
28.
Self-employment/household employment/other federal taxes
..............
28.
.00
▲
.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 in 2019, federal estimated tax payments made
in 2019, and federal taxes paid in 2019 for 2018 and prior years ........
31.
.00
▲
.00
32.
Qualified business income deduction. 25.0% (.25) of federal
amount. See instructions ......................................................................
32.
.00
▲
.00
33.
DPAD 199A(g) deduction. 25.0% (.25) of federal amount ...................
33.
.00
▲
.00
34.
Total federal tax and other qualified deductions. Add lines 31, 32, and 33 ................................................................
.
34.
.00
.00
35.
Balance. Subtract line 34 from line 30. Enter here and on line 36, page 2................................................................
..
35.
.00
▲
.00
PRINT
CLEAR
SELECT COUNTY
41-001 (09/10/19)
2019 IA 1040, page 2
B. Spouse/Status 3
A. You or Joint
B. Spouse/Status 3
A. You or Joint
Step 8
Taxable
Income
36.
BALANCE. From side 1, line 35 ................................................................................................................................
36.
.00
.00
37.
Deduction. Check one box
▲
Itemized.(Include IA Schedule A)
Standard
...............................................
37.
.00
▲
.00
38.
TAXABLE INCOME. SUBTRACT line 37 from line 36 ..............................................................................................
38.
________________
.00
___________________
.00
Step 9
Tax,
Credits,
and
Check
-
off
Contri
-
but
ions
39.
Tax from tables or alternate tax ................................
..........................
39.
.00
▲
.00
40.
Iowa lump-sum tax. See instructions ................................
..................
40.
.00
▲
.00
41.
Iowa alternative minimum tax. Include IA 6251. ................................
.
41.
.00
▲
.00
42.
Total tax. ADD lines 39, 40, and 41. ................................................................................................
........................
42.
.00
.00
43.
Total exemption credit amount(s) from Step 3, side 1.
.......................
43.
.00
.00
44.
Tuition and textbook credit for dependents K-12.
...............................
44.
.00
▲
.00
45.
Volunteer firefighter/EMS/reserve peace officer credit.
......................
45.
.00
▲
.00
46.
Total credits. ADD lines 43, 44, and 45. ................................................................................................
....................
46.
.00
.00
47.
BALANCE. SUBTRACT line 46 from line 42. If less than zero, enter zero. ................................
..............................
47.
.00
▲
.00
48.
Credit for nonresident or part-year resident. Include IA 126 and federal return. ................................
.......................
48.
.00
▲
.00
49.
BALANCE. SUBTRACT line 48 from 47. If less than zero, enter zero. ................................................................
.....
49.
.00
▲
.00
50.
Out-of-state tax credit. Include IA 130. ................................................................................................
......................
50.
.00
▲
.00
51.
BALANCE. SUBTRACT line 50 from 49. If less than zero, enter zero. ................................................................
.....
51.
.00
▲
.00
52.
Other nonrefundable Iowa credits. Include IA 148 Tax Credits Schedule. ................................
................................
52.
.00
▲
.00
53.
BALANCE. SUBTRACT line 52 from line 51. If less than zero, enter zero. ................................
..............................
53.
.00
▲
.00
54.
School district surtax or EMS surtax. Take percentage from table; multiply by line 53. ................................
...........
54.
.00
▲
.00
55.
Total state and local tax. ADD lines 53 and 54. ................................................................................................
.........
55.
.00
▲
.00
56.
TOTAL state and local tax before contributions. Combine columns A and B on line 55 and enter here. .....................................................
56.
.00
57.
Contributions will reduce your refund or add to the amount you owe. Amounts must be in whole dollars.
Fish/Wildlife 57a: ▲
State Fair 57b: ▲
Firefighters/Veterans 57c: ▲
Child Abuse Prevention 57d: ▲
Enter here. ....
57.
.00
58.
TOTAL
STATE AND LOCAL TAX, AND CONTRIBUTIONS. Add line 56 and line 57 and enter here. ........................................................
58.
▲
___________________
.00
Step 10
Credits
59.
Iowa fuel tax credit. Include IA 4136 ................................
....................
59.
.00
▲
.00
60.
Check One: Child and dependent care credit OR
▲ Early childhood development credit
60.
.00
▲
.00
61.
Iowa earned income tax credit. 15.0% (.15) of federal credit
..............
61.
.00
▲
.00
62.
Other refundable credits. Include IA 148 Tax Credits Schedule.
........
62.
.00
▲
.00
63.
Iowa income tax withheld. ................................................................
....
63.
.00
▲
.00
64.
Estimated and voucher payments made for tax year 2019.
................
64.
.00
▲
.00
65.
TOTAL. ADD lines 59 through 64 and enter here
................................
65.
.00
▲
.00
66.
TOTAL CREDITS. ADD columns A and B on line 65 and enter here ................................................................................................
..........
66.
___________________
.00
Step 11
Refund
67.
If line 66 is more than line 58, subtract line 58 from line 66. This is the amount you overpaid. ................................................................
...
67.
▲
.00
68.
Amount of line 67 to be REFUNDED. ......................................................................................................................................... REFUND
68.
▲
.00
68a.
Routing Number:
68b.
Type
Checking
Savings
68c.
Account Number:
69.
Amount of line 67 to be applied to your 2020 estimated tax.
..............
69
.
.00
▲
.00
Step 12
Pay
70.
If line 66 is less than line 58, subtract line 66 from line 58. This is the AMOUNT OF TAX YOU OWE ................................
.......................
70.
▲
.00
71.
Penalty for underpayment of estimated tax from IA 2210, IA 2210S, or IA 2210F. Check if annualized income method is used. ▲
71.
▲
.00
72.
Penalty and interest
▲
72a. Penalty
.00
▲ 72b. Interest
.00
ADD. Enter total. .........
72.
.00
73.
TOTAL AMOUNT DUE. ADD lines 70, 71, and 72. Enter here. ............................................................................... PAY THIS AMOUNT
73.
▲
.00
Step 13
I, the undersigned, declare under penalt
ies of perjury or false certificate, that I have examined this return, and, to the best of my knowledge and belief, it is true, correct, and
complete.
SIGN
HERE
▲
Your Signature
Date
Check if Deceased
Date of Death
Preparer's Signature
Date
SIGN
HERE
▲
Spouse's Signature
Date
Check if Deceased
Date of Death
Preparer's PTIN
Firm's FEIN
Daytime Telephone Number
Daytime Telephone Number
This return is due April 30th, 2020. Sign, enclose W-2s, and verify SSNs.
MAILING ADDRESS: Iowa Income Tax Document Processing,
PO BOX 9187, Des Moines IA 50306-9187
Make check payable to Treasurer, State of Iowa
0.00%
CLEAR
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