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Government of the District of Columbia 2013 D-40 Individual Income Tax Return Print in CAPITAL letters using black ink. Leave lines blank that do not apply. 2013 D-40 P1 Individual Income Tax Return page 1 File order 1 Revised 09/13 STAPLE W-2s AND ANY OTHER WITHHOLDING STATEMENTS HERE Fill in if: Filing an amended return . Fill in if: Filing for a deceased taxpayer See instructions. Personal information Your telephone number Your social security number (SSN) and and Date of Birth (MMDDYYYY) Home address (number, street and apartment number if applicable) City STAPLE OTHER DOCUMENTS IN UPPER LEFT IN BACK ● ● 3 $ . 00 Filing status Single , Dependent claimed by someone else 1 Fill in only one: Enter combined amounts for Lines 4–42. See instructions. Head of household Enter qualifying dependent and/or non-dependent information on Schedule S. 2 Fill in if you are: Part-year resident in DC from (month) to (month); number of months in DC Income Information a Wages, salaries, unemployment compensation and/or tips, b Business income or loss, see instructions. c Capital gain (or loss). d Rental real estate, royalties, partnerships, etc. Computation of DC Gross and Adjusted Gross Income 3 Federal adjusted gross income. From adjusted gross income lines on Federal Forms 1040, 1040A, 1040EZ, 1040NR, or 1040NR-EZ Additions to DC Income 4 Franchise tax deducted on federal forms, see instructions . 5 Other additions from DC Schedule I, Calculation A, Line 8. 6 Add Lines 3, 4 and 5. Subtractions from DC Income 7 Part year residents, enter income received during period of nonresidence, . 8 Taxable refunds, credits or offsets of state and local income tax. 9 Taxable amount of social security and tier 1 railroad retirement 11 DC and federal government pension and annuity limited exclusion, see instructions. see instructions . 13 Other subtractions from DC Schedule I, Calculation B, Line 16. 14 Total subtractions from DC income, Lines 7-13. 15 DC adjusted gross income, Line 6 minus Line 14. a $ . 00 b $ . 00 c $ . 00 d $ . 00 From Federal Forms 1040 or 1040A. Round cents to nearest dollar. If zero, leave the line blank. Fill in if loss Fill in if loss Fill in if loss see instructions. 12 $ . 00 13 $ . 00 14 $ . 00 15 $ . 00 Fill in if loss 4 $ . 00 5 $ . 00 6 $ . 00 Fill in if loss Fill in if loss 7 $ . 00 8 $ . 00 9 $ . 00 10 $ . 00 11 $ . 00 Date of Birth (MMDDYYYY) Spouse’s/registered domestic partner’s SSN Your first name M.I. Last name Spouse’s/registered domestic partner’s first name M.I. Last name State Zip Code Married filing jointly, Married filing separately, Married filing separately on same return filing separately on same return Complete your federal return first – Enter your dependents’ information on DC Schedule S (Not Supported) (Not Supported) (Not Supported) 10 Income reported and taxed this year on a DC franchise or fiduciary return. Fill in if you are 62 or older if your spouse/domestic partner is 62 or older 12 DC and federal government survivor benefits, Registered domestic partners filing jointly or ----------------Page (0) Break---------------- 2013 D-40 P2 Individual Income Tax Return page 2 File order 2 Enter your last name. D-40 PAGE 2 Enter your SSN. spouse/domestic partner are over 65 or blind, attach a completed Calculation G, Schedule S. Refund – Complete if Line 34 is more than Line 27 35 Amount you overpaid Subtract Line 27 from Line 34 36 Amount to be applied to your 2014 estimated tax 37 Penalty See instructions 38 Refund Subtract sum of Lines 36 and 37 from Line 35 39 Contribution amount from Sched. U, Part II, Line 6 Can not exceed refund amt. on Line 38 Put additional amt. on Line 42 40 Net refund Subtract Line 39 from Line 38 See instructions. Refund Options: . Direct Deposit. To have your refund deposited to your . Third party designee Signature 44 Total amount due Add Lines 41–43 42 Contribution amount from Sched. U, Part II, Line 7 41 Tax due Subtract Line 34 from Line 27 Fill in if loss 17 $ . 00 19 $ . 00 20 $ . 00 21 $ . 00 From Federal form 2441; if part-year DC resident, from Line 5, DC Form 2441 41 $ . 00 Preparer’s signature Date Your signature Date 42 $ . 00 43a Penalty $ . 00 43b Interest $ . 00 Enter total P & I 43 $ . 00 44 $ . 00 18 36 $ 00 35 $ 00 22 $ . 00 23 $ . 00 26 $ . 00 27 $ . 00 24 $ . 00 25 $ . 00 28 $ . 00 29 $ . 00 30 $ . 00 31 $ . 00 32 $ . 00 33 $ . 00 34 $ . 00 25a 28a .00 X .40 Enter result > $ .00 X .32 Enter result > $ 16 Deduction type. Take the same type as you took on your federal return. Fill in which type: Standard or Itemized See instructions for amount to enter on Line 17. 17 DC deduction amount. Do not copy from federal return. For amount to enter, see instructions. 18 Number of exemptions. 19 Exemption amount. Multiply $1,675 by number on line 18. Part-year DC residents see Calculation E, see instructions . 20 Add Lines 17 and 19. 21 DC taxable income. Subtract Line 20 from Line 15. Enter result. DC tax, credits and payments 22 Tax. Fill in Complete Calculation J on Schedule S. 23 Credit for child and dependent care expenses 24 Non-refundable credits from DC Schedule U, Part 1a, Line 6. Attach Schedule U. 25 DC Low Income Credit. 25a Enter the number of exemptions claimed on your federal return. 26 Total non-refundable credits. Add Lines 23, 24 and 25. 27 Total tax. Subtract Line 26 from Line 22. If Line 22 is less than Line 26 leave Line 27 blank. 28 DC Earned Income Tax Credit. Enter your federal EIC. 29 Property Tax Credit. From your DC Schedule H; attach a copy . 30 Refundable credits from DC Schedule U, Part 1b, Line 4. Attach Schedule U. 31 DC income tax withheld shown on Forms W-2 and 1099. Attach these forms. 32 2013 estimated income tax payments. 33 34 Total payments and refundable credits Add Lines 28, 29–33. Amount owed – Complete if Line 34 is equal to or less than Line 27 37 $ 00 38 $ 00 39 $ 00 40 $ 00 If more than 1 (more than 2 if filing jointly), or if you or your if filing separately on same return. 28a Enter the number of qualified EITC children. Tax paid with extension of time to file or with original return if this is an amended return. Mark one refund choice: Direct deposit Tax refund card Paper check checking OR savings Will the refund you requested go to an account outside the U.S.? Yes No Routing Number Account Number To authorize another person to discuss this return with OTR, fill in here and enter the name and phone number of that person. See instructions. Designee’s name Phone number Under penalties of law, I declare that I have examined this return and, to the best of my knowledge, it is correct. Declaration of paid preparer is based on information available to the preparer. Spouse’s/domestic partner’s signature if filing jointly or separately on same return Date Preparer's Tax Identification Number (PTIN) PTIN telephone number account, check the box and enter bank routing and account numbers. See instructions For information on the tax refund card and program limitations, see instructions or visit our website otr.dc.gov/refundprepaidcards Use Calc. LIC/EITC to see if LIC or EITC is a greater benefit. See instructions. If Line 21 is $100,000 or less, use tax tables to find the tax, If more, use Calculation I in instructions. Check the box if Form D-2210 is attached Check the box if Form D-2210 is attached ----------------Page (1) Break----------------