pdf2json/test/data/pa/form/SCHO.content.txt

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Beneficiary
 
Information:
 
Contributions
 
by:
 
Name:
 
 
 
 
 
Spouse
 
 
1.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2.
 
 
 
 
 
 
 
 
 
 
 
1301610026
 
 
 
 
-
 
2013
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2.
 
 
 
 
 
 
 
 
 
3.  
 
 
 
 
 
 
 
 
 
3.
 
 
 
4.  
 
 
 
 
 
 
 
 
 
4.
 
 
 
5.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5.
 
 
 
6.  
 
 
 
 
 
 
 
 
 
 
 
 
 
6.
 
 
 
7.  
 
 
 
 
 
 
 
 
 
 
 
 
7.
 
 
 
 
8.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
8.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1301610026
 
1301610026
 
PA SCHEDULE O
Other Deductions
PA-40 Schedule O
(06-13)
OFFICIAL USE ONLY
Name shown first on the PA-40 (if filing jointly)  
Social Security Number (shown first)
(See the instructions.)
additional schedules).
Medical Savings Account contributions allowed for federal purposes.
Health Savings Account contributions allowed for federal purposes.
Enter here and on Line 10 of your PA-40.
PART I - IRC Section 529 Qualified Tuition Program Contributions
(Limit $14,000 per beneficiary, per taxpayer-spouse.)
Add Lines 2, 3 and 4 and enter amounts here for tax payer and/or spouse.
Total income reported on PA-40 Line 9 by taxpayer and spouse separately.
Lesser of Line 5 or Line 6 for taxpayer and/or spouse.
- Add the amounts from Line 7 for taxpayer and/or spouse together.
Total Other Deductions
PART II - Other Deductions and Limitations
Total IRC Section 529 Contributions
Social Security Number
Taxpayer
- Add all amounts listed (including amounts on
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