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30751028 SC1040 (Rev. 8/20/13) 3075 STATE OF SOUTH CAROLINA DEPARTMENT OF REVENUE 2013 INDIVIDUAL INCOME TAX RETURN . . . . . . . . . . . . . . . . . Check this box if you have filed a federal or state extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check this box if this return is affected by a federally declared DISASTER AREA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter the name of the combat zone: Enter the name of the disaster area: CHECK YOUR (1) Enter spouse's SSN here : FEDERAL FILING STATUS (2) Married filing jointly (4) Head-of -household (5) Widow(er) with dependent child . . . Federal Exemptions . . . . . . Dependents: Print your first name and initial Last name Spouse’s first name, if ma rried filing jointly Last name Check if new address Zip State Area code Daytime telephone City Check if address is outside US Foreign country address including Postal code (see instructions) County code Mailing address (number and street, Apt. no or P. O. Box) Foreign address, see instructions Suff. Social security number Relationship Date of birth (MM/DD/YYYY) 1350 Your social security number Check if deceased Spouse's social security number Check if deceased DO NOT USE THIS FORM TO FILE A CORRECTED RETURN. SEE SC1040 INSTRUCTIONS FOR ADDITIONAL INFORMATION. For the year January 1 - December 31, 2013, or fiscal tax year beginning 2013 and ending 2014 (Not Supported) (Not Supported) Check this box if you are filing SC Schedule NR (Part year/Nonresident) . . . . . . . . . . . . . . . . . . . . . . . . . . . Check this box ONLY if filing a composite return on behalf of the nonresident partners/shareholders of a partnership or "S" corporation . Check this box if you served in a Military COMBAT ZONE during the filing period . . . . . . . . . . . . . . . . . . . . . . . Enter the number of exemptions from your 2013 federal return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter the number of exemptions listed above that were under the age of 6 years on December 31, 2013 . . . . . . . Enter the number of taxpayers age 65 or older, as of December 31, 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . First name Last name Single (3) Married filing separately. Enter additional dependents (Not Supported) (Not Supported) ----------------Page (0) Break---------------- This is your .......................................... states and political subdivisions Other additions to income. Attach an explanation SUBTRACTIONS FROM FEDERAL TAXABLE INCOME Out-of-state income/gain – Do not include personal service income f g h i j 00 Add lines f through v and enter here. These are your total subtractions .............................. 4 South Carolina INCOME SUBJECT TO TAX 5 00 4 5 44% of net capital gains held for more than one year Active Trade or Business Income deduction Certain nontaxable National Guard or Reserve Pay q l m n o p or the SC Tuition Prepayment Program k Caution: Retirement Deduction (See instructions) Spouse: date of birth . . . . . . . . . . . . . . . . . . . . . . . . . Age 65 and older deduction Taxpayer: date of birth . . . . . . . . . . . . . . . . . . . . . . . . . Spouse: date of birth . . . . . . . . . . . . . . . . . . . . . . . . . Negative amount of federal taxable income . . . . . . . . . . . . . . . . . . . . . . . . . . . Consumer Protection Services ........................................... r s t 30752026 TAX 6 00 6 7 00 8 00 9 00 Add lines 6 through 9 and enter the total here TOTAL SOUTH CAROLINA TAX 10 10 11 00 12 00 TAX on Lump Sum Distribution (Attach SC4972) ........................... 7 TAX on Active Trade or Business Income (Attach I-335) ..................... 8 9 Child and Dependent Care . 11 Two Wage Earner Credit 12 00 00 00 q-1 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 f g h i j l m n o 00 r s t k 00 Dollars 00 Add lines a through e and enter the total here. These are your total additions .......................... 2 Add lines 1 and 2 and enter the total here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 00 2 3 u u Dollars 1 1 ADDITIONS TO FEDERAL TAXABLE INCOME State tax add back,if itemizing on federal return Out-of-state losses (See instructions) Interest income on obligations of other than a b c d e a b c 00 d 00 00 00 00 00 e INCOME AND ADJUSTMENTS p-1 p-3 p-1 p-2 p-3 p-4 p-2 p-4 q-2 q-1 q-2 00 00 14 . . . . 15 SUBTRACT line 14 from line 10. Enter the difference BUT NOT LESS THAN ZERO here . . . . . . . . . . . . . . . . . . . . . 15 14 00 13 00 13 Page 2 of 3 Reserve Police Taxpayer: date of birth . . . . . . . . . . . . . . . . . . . . . . . . . Nonresident filers complete Schedule NR and enter total from line 50 on line 5 below .................... . . . . 2013 Other subtractions 00 v v .............. Check type of loss: Rental Business Other . . . Expenses related to National Guard and Military Reserve income . . . . . . . . . . . . ............ State tax refund, if included on your federal return . . . . . . . . . . . . . . . . . . . . . . . Check type of income/gain: Rental Business Other ........ Firefighter HazMat Rescue Squad DNR Other Total and permanent disability retirement income, if taxed on your federal return Volunteer deductions (See instructions) Check type of deduction: Contributions to the SC College Investment Program (“Future Scholar”) ................. Interest income from obligations of the US government . . . . . . . . . . . . . . . . . . . . . ......... (See instructions) (See instructions) (See instructions) ..................... (See instructions) (See instructions) (See instructions) Social security and/or railroad retirement, if taxed on your federal return . . . . . Surviving spouse #1: date of birth of deceased spouse . . Surviving spouse #2: date of birth of deceased spouse . . (See instructions) Subsistence allowance days @ $8.00 . . . . . . . . . . . . . . . . . . . . . . . . . . Dependents under the age of 6 years on December 31 of the tax year . . . . . . ....................................... (See instructions) Residents subtract line 4 from line 3 and enter the difference. Nonresidents enter amount from Schedule NR, .......... ........................... .................................. .................................... (See instructions) (See instructions) Other non-refundable credits. Attach SC1040TC and other state return(s) . . . . . . TOTAL non-refundable credits. Add lines 11 through 13 and enter the total here . . . . . . . . . . . . . . . . . . . . . . . . line 50. If less than zero, enter zero here TAX on excess withdrawals from Catastrophe Savings Accounts . . . . . . . . . . . . . ............. ..... South Carolina : enter tax from South Carolina tax tables (Not Supported) Enter federal taxable income from your federal form. If zero or less, enter zero here. ----------------Page (1) Break---------------- here. Prepare SC1040-V 30753024 19 00 00 00 00 16 SC INCOME TAX WITHHELD 00 00 18 Amount paid with extension . . 00 Check type: Page 3 of 3 22 Other refundable credit(s) 17 2013 estimated tax payments 20 Other SC withholding (Attach Form 1099) ....... 21 Tuition tax credit (Attach I-319) ............ Milk Credit (Attach I-334) Anhydrous Ammonia (Attach I-333) PAYMENTS AND REFUNDABLE CREDITS 2013 Classroom Teacher Expenses (Attach I-360) 34 30 AMOUNT TO BE REFUNDED TO YOU (line 30a check box entry is required) ................ REFUND 31 Penalty for Underpayment of Estimated Tax 33 32 Add lines 31 through 33 and enter the AMOUNT YOU OWE BALANCE DUE 29 26 27 USE TAX: 26 Amount of line 24 to be credited to your 2014 Estimated Tax ............... 27 28 Total Contributions for Check-offs (Attach I-330) ........................... Add lines 26 through 28 and enter the total here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 00 31 00 00 00 00 00 00 00 29 33 32 34 30 Late filing and/or late payment: Penalties _________ Interest ________ 00 00 23 Add lines 16 through 22 and enter the total here.. TOTAL PAYMENTS 24 25 23 25 24 00 (See instructions and enter letter in box if applicable) Exception to Underpayment of Estimated Tax 00 No Preparer's printed name Yes I authorize the Director of the Department of Revenue or delegate to Check here and enter your email address if you wish to receive information about obtaining your 1099-G/INT Income Tax Refund statement electronically. Date Check if self- employed FEIN PTIN Date Your signature Go Paperless! SCDOR will offer the option to receive your Form 1099-G/INT electr onically instead of receiving it in the mail. Form 1099-G/INT is used when preparing your federal tax return. Email Address REFUND OPTIONS (subject to program limitations) 30a Mark one refund choice: 30b Direct Deposit (for US Accounts Only) Type: Checking Savings Routing Number (RTN) Bank Account Number (BAN) Direct Deposit (30b required) Debit Card* Paper Check *SCDOR Income Tax Refund Prepaid Debit Card issued by Bank Of America 1-17 digits Must be 9 digits. The first two numbers of the RTN must be 01 through 12 or 21 through 32 Paid Preparer's Use Only Preparer signature Firm name (or yours if self-employed) and address and Zip Code BALANCE DUE REFUNDS OR ZERO TAX SC1040 Processing Center, PO Box 101100, Columbia, SC 29211-0100 Taxable Processing Center, PO Box 101105, Columbia, SC 29211-0105 MAIL TO: Phone No. ........... ...... (Attach W-2 or SC41) NR sale of real estate ...................... These are your If line 23 is LARGER than line 15, subtract line 15 from line 23 and enter the OVERPAYMENT . . . . . . . . . . . . . . . . If line 15 is LARGER than line 23, subtract line 23 from line 15 and enter the AMOUNT DUE . . . . . . . . . . . . . . . . . . ......................................... (See instructions) If line 29 is larger than line 24, go to line 31. Otherwise, subtract line 29 from line 24 and enter the Tax Due: Add lines 25 and 29. If line 29 is larger than line 24, subtract line 24 from line 29 and enter the amount . . (See instructions) ..... .................... Enter total here (Attach SC2210) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (EFW) or include SC1040-V with your check or money order for the fu Pay electronically free of charge at www.sctax.org. Click on DORePay and pay with Visa, Master Card or by Electronic Funds Withdrawal Spouse's signature (if married filing jointly, BOTH must sign) discuss this return, attachments and related tax matters with the preparer. If prepared by a person other than the taxpayer, his declaration is based on all information of which he has any knowledge. I declare that this return and all attachments are true, correct and complete to the best of my knowledge and belief. ll amount payable to “SC Department of Revenue”. Write your social security number and “2013 SC1040” on the payment. (Not Supported) (Not Supported) (Not Supported) ----------------Page (2) Break----------------