Kentucky Individual Income Tax Return Form
The following Income Tax Return form has to be completed and submitted annually by all residents of the State of Kentucky.
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00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 A. Spouse’s Social Security Number B. Your Social Security Number Name—Last, First, Middle Initial (Joint or combined return, give bot\ h names and initials.) Mailing Address (Number and Street including Apartment Number or P.O. B\ ox) City, Town or Post Office State ZIP Code Attach Form W-2(s), Other Supporting Statement(s) and Payment Here—\ Staple to Top Page Only For calendar year or other taxable year beginning _________ , 2012, and \ ending ________ , 20____ . 74042A740Department of Revenue 2012 FILING STATUS (see instructions) 1 Single 2 Married , filing separately on this combined return. (If both had income.) 3 Married , filing joint return. 4 Married , filing separate returns. Enter spouse’s Social Security number ab\ ove and full name here. POLITICAL PARTY FUND Designating $2 will not change your refund or tax due. A. Spouse B. Yourself Democratic (1) (4) Republican (2) (5) No Designation (3) (6) A. B. KENTUCKY INDIVIDUAL INCOME TAX RETURN Full-Year Residents Only *1200020001* Spouse (Use if Yourself Filing Status 2 is checked.) (or Joint) INCOME/TAX 5 Enter amount from federal Form 1040, line 37; 1040A, line 21 or 1040EZ, line 4. (If total of Columns A and B is $30,657 or less, you may qualify for the Family Size Tax Credit. See instructions.) .................... • 5 • 5 6 Additions from Schedule M, line 8 .................................................................... • 6 • 6 7 Add lines 5 and 6 ........................................................................\ ........................ 7 7 8 Subtractions from Schedule M, line 20 ............................................................. • 8 • 8 9 Subtract line 8 from line 7. This is your Kentucky Adjusted Gross Income ... 9 9 10 Itemizers: Enter itemized deductions from Kentucky Schedule A. Nonitemizers: Enter $2,290 in Columns A and/or B ........................................ • 10 • 10 11 Subtract line 10 from line 9. This is your Taxable Income ............................. • 11 • 11 12 Enter tax from Tax Table, Computation or Schedule J. Check if from Schedule J ........................................................................\ ... 12 12 13 Enter tax from Form 4972-K ; Schedule RC-R .................................... • 13 • 13 14 Add lines 12 and 13 and enter total here ......................................................... 14 14 15 Enter amounts from page 3, Section A, lines 22A and 22B ............................ 15 15 16 Subtract line 15 from line 14. If line 15 is larger than line 14, enter \ zero ....... 16 16 17 Enter personal tax credit amounts from page 3, Section B, lines 4A and 4\ B • 17 • 17 18 Subtract line 17 from line 16. If line 17 is larger than line 16, enter \ zero ....... 18 18 19 Add tax amount(s) in Columns A and B, line 18 and enter here ........................................................................\ ...... 19 20 Check the box that represents your total family size ( see instructions before completing lines 20 and 21) ........ • 20 1 2 3 4 21 Multiply line 19 by Family Size Tax Credit decimal amount __ . __ __ (__ __ __%) and enter here ...................... • 21 22 Subtract line 21 from line 19 ........................................................................\ ................................................................ 22 23 Enter the Education Tuition Tax Credit from Form 8863-K ........................................................................\ ............... • 23 24 Subtract line 23 from line 22 ........................................................................\ ................................................................ 24 25 Enter Child and Dependent Care Credit from federal Form 2441, line 9 ➤ x 20% (.20) ............................................. • 25 26 Income Tax Liability. Subtract line 25 from line 24. If line 25 is larger than line 24, enter \ zero ............................ 26 27 Enter KENTUCKY USE TAX due on Internet, mail order, or other out-of-stat\ e purchases (see instructions) • 27 28 Add lines 26 and 27. Enter here and on page 2, line 29 ........................................................................\ ................... 28 FORM 740 (2012) Page 2 of 3 *1200020002* REFUND OWE SECTION A—BUSINESS INCENTIVE AND OTHER TAX CREDITS 1 Enter nonrefundable limited liability entity credit (KRS 141.0401(2))\ ................. 1 00 1 00 2 Enter Kentucky small business investment credit ................................................. 2 00 2 00 3 Enter skills training investment credit (attach copy(ies) of certifi\ cation) ............. 3 00 3 00 4 Enter nonrefundable certified rehabilitation credit (KRS 171.397(1)\ (a)) .............. 4 00 4 00 5 Enter credit for tax paid to another state (attach copy of other state’s return(s)) 5 00 5 00 6 Enter unemployment credit (attach Schedule UTC) .............................................. 6 00 6 00 7 Enter recycling and/or composting equipment credit (attach Schedule RC)\ ....... 7 00 7 00 8 Enter Kentucky investment fund credit (attach copy(ies) of certific\ ation) ........... 8 00 8 00 9 Enter coal incentive credit ........................................................................\ ................ 9 00 9 00 10 Enter qualified research facility credit (attach Schedule QR) ................................ 10 00 10 00 11 Enter GED incentive credit (attach Form DAEL-31) ................................................ 11 00 11 00 12 Enter voluntary environmental remediation credit (attach Schedule VERB)\ ....... 12 00 12 00 13 Enter biodiesel and renewable diesel credit ........................................................... 13 00 13 00 14 Enter environmental stewardship credit ................................................................. 14 00 14 00 15 Enter clean coal incentive credit ........................................................................\ ...... 15 00 15 00 16 Enter ethanol credit (attach Schedule ETH) ............................................................ 16 00 16 00 17 Enter cellulosic ethanol credit (attach Schedule CELL) ......................................... 17 00 17 00 18 Enter energy efficiency products credit (attach Form 5695-K) .............................. 18 00 18 00 Continue to page 3 to complete Section A A. Spouse B. Yourself PWR OFFICIAL USE ONLY l Make check payable to Kentucky State Treasurer or visit www.revenue.ky.gov for more options. l Write your Social Security number and “KY Income Tax—2012” on t\ he check. 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 REFUND/TAX PAYMENT SUMMARY 29 Enter amount from page 1, line 28. This is your Total Tax Liability ....................................................................... • 29 30 (a) Enter Kentucky income tax withheld as shown on attached 2012 Form W-2(s) and other supporting statements ....................................... • 30(a) (b) Enter 2012 Kentucky estimated tax payments .................................................. • 30(b) (c) Enter 2012 refundable certified rehabilitation credit (KRS 141.382(\ 1)(b)) ..... • 30(c) (d) Enter 2012 film industry tax credit (KRS 141.383) ........................................... • 30(d) 31 Add lines 30(a) through 30(d) ........................................................................\ .............................................................. • 31 32 If line 31 is larger than line 29, enter AMOUNT OVERPAID (see instructions) ........................................................ 32 Fund Contributions; See instructions. ➤ (Enter amount(s) checked) 33 Nature and Wildlife Fund ............................................ $10 $25 $50 Other • 33 34 Child Victims’ Trust Fund ........................................... $10 $25 $50 Other • 34 35 Veterans’ Program Trust Fund ................................... $10 $25 $50 Other • 35 36 Breast Cancer Research/Education Trust Fund ....... $10 $25 $50 Other • 36 37 Add lines 33 through 36 ........................................................................\ ....................................................................... 37 38 Amount of line 32 to be CREDITED TO YOUR 2013 ESTIMATED TAX .................................................................... • 38 39 Subtract lines 37 and 38 from line 32. Amount to be REFUNDED TO YOU ................................. • 39 40 If line 29 is larger than line 31, enter ADDITIONAL TAX DUE ........................................................................\ .......... • 40 41 (a) Estimated tax penalty and/or interest. Check if Form 2210-K attached ... 41(a) (b) Interest ........................................................................\ ......................................... 41(b) (c) Late payment penalty ........................................................................\ ................. 41(c) (d) Late filing penalty ........................................................................\ ........................ 41(d) 42 Add lines 41(a) through 41(d). Enter here ........................................................................\ ........................................... • 42 43 Add lines 40 and 42 and enter here. This is the AMOUNT YOU OWE ................................................ 43 FORM 740 (2012) Page 3 of 3 *1200020040* REFUNDS Kentucky Department of Revenue, Frankfort, KY 40618-0006. PAYMENTS Kentucky Department of Revenue, Frankfort, KY 40619-0008. Mail to: SECTION B—PERSONAL TAX CREDITS Check Regular Check both if 65 or over Check both if blind 1 (a) Credits for yourself: (b) Credits for spouse: 2 Dependents: Dependent’s Check if qualifying Dependent’s relationship child for family First name Last name Social Security number to you size tax credit 3 Add total number of credits claimed on lines 1 and 2. If married filing separately on a combined return (Filing Status 2),\ each taxpayer must claim his or her own credits from line 1, divide the credits on line 2, and enter the tot\ als in Boxes 3A and 3B. All other filers enter the amount from line 3 in Box 3B ........................................................................\ ................................ ➤ • 3A • 3B 4 Multiply credits on line 3A by $20 and enter on line 4A. Multiply credit\ s on line 3B by $20 and x $20 x $20 enter on line 4B. Enter here and on page 1, line 17, Columns A and B .................................................................. 4A 4B 1 Enter number of boxes checked on line 1 ........................ 2 Enter number of dependents who: • lived with you ............ • did not live with you (see instructions) ....... • other dependents ...... 3 Enter total credits ......... Yourself Spouse SECTION C—FAMILY SIZE TAX CREDIT (List the name and Social Security number of qualifying children that a\ re not claimed as dependents in Section B.) First name Last name Social Security number First name Last name Social Security number Attach a complete copy of federal Form 1040 if you received farm, busine\ ss, or rental income or loss. If not required, check here. I, the undersigned, declare under penalties of perjury that I have examined this return, including all accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. I also understand and agree that our election to file a combined return under the provisions of Regulation 103 KAR 17:020 will result in refunds being made payable to us jointly and in each of us being jointly and severally liable for all taxes accruing under this return. Your Signature (If joint or combined return, both must sign.) Spouse’s Signature Date Signed Typed or Printed Name of Preparer Other than Taxpayer I.D. Number of Preparer Date Firm Name EIN Date Telephone Number (daytime) ( ) SECTION A—BUSINESS INCENTIVE AND OTHER TAX CREDITS (continued) 19 Enter railroad maintenance and improvement credit (attach Schedule RR-I\ ) ..... 19 00 19 00 20 Enter Endow Kentucky credit (attach Schedule ENDOW) ..................................... 20 00 20 00 21 Enter New Markets Development Program credit ................................................. 21 00 21 00 22 Add lines 1 through 21, Columns A and B. Enter here and on page 1, line 15 . 22 00 22 00 A. Spouse B. Yourself
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