New Mexico General Information

Transcription

1 NMGen New Mexico General Information Return Information NMGen (0) NM Address new or changed Disaster relief description General footnote Contributions Political Contributions Political party: ( = Democratic, = Republican, = Libertarian, = Independent American, = Constitution, = Green) Taxpayer Spouse Share with Wildlife Veterans' State Cemetery Fund New Mexico Substance Abuse Education Fund New Mexico Forest Re-Leaf Program National Guard Member and Family Assistance Kids 'N Parks Transportation Grant Program Amyotrophic Lateral Sclerosis Research Fund Vietnam Veterans' Memorial State Park Veterans' Enterprise Fund Lottery Tuition Fund Horse Shelter Rescue Fund Animal Care and Facility Fund Supplemental Senior Services Charitable Contributions 0,, 0 INDIVIDUAL

2 NMEst New Mexico Estimates Overpayment Application NMEst (0) NM Application of 0 overpayment = Refund 00% of overpayment = Apply amount specified below to estimates until exhausted, refund excess = Apply 00% of overpayment to 0 estimate, refund excess = Apply to first and second estimates, refund excess = Apply to first estimate, refund excess = Apply 00% of overpayment to 0 estimates, no refund = Apply equally to each estimate, refund excess = Apply amount specified below to 0 Amount for code or Do not calculate estimates for code or (If Estimates - declaration for 0 is blank) Estimates - declaration for 0 = Use 0 liability (Default when overpayment applied to 0) = Use 0 liability adjusted by amount below = Use 0 liability even if less than $,000 = Print vouchers with amount fields blank * = Use amounts entered below, before overpayment Number of 0 vouchers desired = Four vouchers A = First voucher Estimates - Calculated State estimated payments for 0 are entered on federal Screen St Pmt. = Last three vouchers B = Second voucher *Adjust printing of filing instructions on federal Screen Est for codes and. = Last two vouchers C = Third voucher = Use 0 amounts adjusted by amounts below = Suppress printing of vouchers * = Use tax from Tax Projection Worksheet (Resident or nonresident states only) = Use amounts entered below Withholding adjustment Amount for code Amounts for code, or 0 estimates paid: st payment nd payment rd payment th payment 0 Amounts for code : Taxable income Tax Credits Options for code (A = 0%, C = Add desired refund amount) Amount of refund desired Do not proforma 0 declaration code, use code or code for 0 estimates = Use current year liability, = Use current year liability even if less than $,000 = Last voucher Amounts for code or 0 Estimates paid 0 Amount to round up each estimate Treat th quarter estimate as due on //,, 0 INDIVIDUAL

3 NMCR- New Mexico Refundable Credits General Information Not physically present for at least six months during the year (Force) (Residents only) Inmate of a public institution for more than months during the year: Household members that DO NOT qualify If filing status is Married filing separate, enter the number of exemptions spouse claimed Modified Gross Income Taxpayer NMCR- (0) Spouse NM Wages, salaries, tips, etc (Force) Social security, pensions, annuities and railroad retirement (Force) Unemployment benefits (Force) Worker's compensation benefits (Force) Public assistance and TANF Supplemental security income (SSI) Net profit from business, farm or rentals (Force) Capital gains undiminished by capital losses (Force) Gifts of cash or marketable tangible items received Other income Credit Information Person or Older - Property Tax Rebate 0 Tax billed for the calendar year on principal place of residence (Force) Amount of rent paid during the tax year for principal place of residence Rent includes amount paid on your behalf by a government entity Additional Low Income Property Tax Rebate for Los Alamos or Santa Fe County Residents Only Resident county ( = Los Alamos, = Santa Fe) Tax billed for the calendar year on principal place of residence (Force) Other Refundable Credits 0 Child Day Care Credit (Only enter unreimbursed expenses) Renewable Energy Production tax credit Film Production tax credit Technology Jobs and Research and Development (Additional) tax credit,, 0 INDIVIDUAL

4 NMAdj New Mexico Income and Adjustments Income Modifications Enter interest and dividend income on federal Screen B&D, federal Screen K-, federal Screen KT and federal Screen K-St NMAdj (0) NM Section college savings plan refunds Additions Deductions Enter contributions to college savings plans on federal Screen 0Q. Enter code in the State use field. Lump sum distribution for 0 year average OR Capital gains election on Form (Force) Income of members of a New Mexico federally recognized Indian nation Other than amounts entered on federal Screen W using state use code or federal Screen Income or federal Screen 0M using state use code Name of the taxpayer's Indian nation, tribe or pueblo Name of the spouse's Indian nation, tribe or pueblo Income of taxpayer 00 years of age or older Income of spouse 00 years of age or older Adjustment for medical care savings account Section college savings plan contributions (New Mexico approved plans only) Net capital gains deduction (Force) Medical care expenses (Force)(Used on Medical Care Worksheet to calculate medical care exemption, adjustments, and credits) Organ donation-related expenses National Guard insurance tax exemption Non-resident US Public Health Services active duty pay Itemized Deduction Adjustment 0 Adjustment to itemized deduction for Land Conservation Incentives Credit,, 0 INDIVIDUAL

5 NMPRR New Mexico Preparer Review Federal Adjusted Gross Income and Additions NMPRR (0) NM Federal adjusted gross income Interest and dividends from municipal obligations Federal net operating loss carryforward (Enter as a positive number) Section plan refunds and other additions Subtractions Federal standard or itemized deduction Federal exemptions Low and middle-income tax exemption New Mexico municipal income New Mexico net operating loss carryforward US obligations Railroad Tier I and II Income earned by an Indian 00 year old exemption Exemption age or blind Medical care savings account New Mexico plan contributions Net capital gains deduction Nonresident military wages Medical care exempt (Form PIT-ADJ) Deduction for organ donation National Guard member life insurance Taxable refunds, credits or offsets Medical care expense deduction (Form PIT-) 0 0 Tax, Credits, Payments and Contributions Tax Tax (If Form PIT-B was used to calculate tax then the lump sum tax is included in this total) Lump sum tax Credit tax paid to other state Other nonrefundable credits (Form PIT-CR) Nonrefundable Credits Rebates, Refundable Credits and Payments Rebates and credits (Form PIT-RC) Income tax withheld Oil and gas withholding Pass-through entity withholding Estimates Other payments 0 Refund contributions Contributions,, 0 INDIVIDUAL

6 NMWage New Mexico Allocation of Wages T, S Employer's name General Information Default wages to be apportioned transfer only when New Mexico is present on federal Screen W Wages to be apportioned (Force) Number of days worked outside New Mexico Total working days during the taxable year (Force) (Default = 0) Annual leave earned during taxable year Sick leave earned during the taxable year Holiday leave earned during the taxable year Administrative leave earned during the taxable year Jury Duty leave earned during taxable year Other days Pay rate per day (Force)(If different than calculated amount) Federal wages, Box (Default) Force NMWage (0) 0 NM,, 0 INDIVIDUAL

7 NMSTCr New Mexico Credit Taxes Paid Other State State and Income Information NMSTCr (0) NM State postal code State name Tax paid to above state Total income taxed by other state Income subject to taxation in New Mexico and other state Calculated 0 Force,, 0 INDIVIDUAL

8 NMYr New Mexico Two Year Comparison Federal Adjusted Gross Income and Additions Enter amounts from 0 Form PIT- Federal adjusted gross income Interest and dividends from municipal obligations Federal net operating loss carryforward (Enter as a positive number) Section plan refunds and other additions Subtractions Federal standard or itemized deduction Federal exemptions Low and middle-income tax exemption New Mexico municipal income New Mexico net operating loss carryforward US obligations Railroad Tier I and II Income earned by an Indian 00 year old exemption Exemption age or blind Medical care savings account New Mexico plan contributions Net capital gains deduction Nonresident military wages Medical care exempt (Form PIT-ADJ) Deduction for organ donation National Guard member life insurance Taxable refunds, credits or offsets Medical care expense deduction (Form PIT-) Lump sum tax Tax, Credits, Payments and Contributions Tax Tax (If Form PIT-B was used to calculate tax then the lump sum tax is included in this total) 0 0 NMYr (0) NM Credit tax paid to other state Other nonrefundable credits (Form PIT-CR) Nonrefundable Credits Rebates, Refundable Credits and Payments Rebates and credits (Form PIT--RC) Income tax withheld Oil and gas withholding Pass-through entity withholding Estimates Other payments 0 Refund contributions Penalties and interest Contributions, Penalties and Interest,, 0 INDIVIDUAL

9 NMTPW New Mexico Tax Projection Worksheet General Information 0 items that will not default to 0 amounts are marked with an asterisk (*) Print Tax Projection Worksheet NMTPW (0) NM Federal Adjusted Gross Income and Additions Federal adjusted gross income (If different from the Federal Tax Projection Worksheet) Interest and dividends from municipal obligations Federal net operating loss carryforward (Enter as a positive number) Section plan refunds and other additions * * * Subtractions Federal standard or itemized deduction (If different from the Federal Tax Projection Worksheet) Federal exemptions (If different from the Federal Tax Projection Worksheet) Low and middle-income tax exemption New Mexico municipal income New Mexico net operating loss carryforward US obligations Railroad Tier I and II (Force) Income earned by an Indian 00 year old exemption Exemption age or blind Medical care savings account New Mexico plan contributions Net capital gains deduction Nonresident military wages Medical care exempt (Form PIT-ADJ) Deduction for organ donation National Guard member life insurance Taxable refunds, credits or offsets Medical care expense deduction (Form PIT-) Tax, Credits, and Payments Tax Tax (Force)(If Form PIT-B was used to calculate tax then the lump sum tax is included in this total) Lump sum tax * * * * * * * * 0 0 Credit tax paid to other state Other nonrefundable credits (Form PIT-CR) Nonrefundable Credits * Rebates, Refundable Credits and Payments Rebates and credits (Form PIT-RC) Income tax withheld Oil and gas withholding Pass-through entity withholding Estimates (Force) * Other payments * 0,, 0 INDIVIDUAL

10 NMAmend New Mexico Amended Return NMAmend (0) General Information ONLY enter data from original return WHERE DIFFERENT from amended data; enter AMENDED data where indicated. Transfer original information Explanation for amended return Suppress direct deposit of refund (Bank information is entered on screen NMInfo) Disaster relief description Income and Modifications NM0 Federal adjusted gross income State and local income or general sales tax claimed on Line of federal Schedule A Additions to federal income (Total additions from original Form PIT-ADJ) Federal standard or itemized deduction Federal exemption amount Low and middle-income tax exemption Deductions and exemptions from federal income (Total deduction and exemptions from original Form PIT-ADJ) Medical care expenses 0 Tax and Credits Tax Tax on lump sum distributions Credit for taxes paid to other states (Residents and part year residents only) Nonrefundable credits (Total non-refundable credits from original Form PIT-CR) Rebates and credits (Total rebates and credits claimed from original Form PIT-RC) Working families tax credit Refundable credits (Total refundable credits from original Form PIT-CR) Federal EIC 0 Original Payments, Donations, Penalty and Interest Withholdings Oil and gas withholdings Pass-through entity withholdings Estimates Other payments Refund donations (Total from original Form PIT- D) Amount to apply to 0 Penalty on underpayment Penalty (Failure to file and failure to pay from original return) Interest (Late payment from original return) 0 Amended Payments and Overpayment Applied Payments on previously filed returns or made with payment schedule Refund on previously filed returns Amount of amended refund to apply to next year,, 0 INDIVIDUAL

11 NMBank New Mexico Direct Deposit, Electronic Funds Withdrawal Direct Deposit and Electronic Funds Withdrawal NMBank (0) NM Suppress direct deposit of New Mexico refund Use Refund Advantage for refund deposit (Available when filing electronically and bank product is selected on federal Screen RAL) Enable electronic funds withdrawal for a balance due return (Electronic filing only) Date of withdrawal (If other than original due date of return) Amount of withdrawal (If other than balance due on return) Account Information Enter account information for New Mexico direct deposit or electronic funds withdrawal. Primary account information transfers from federal Screen Bank. Electronic funds withdrawal for balance due returns can be done through a checking account only. Routing transit number Name of financial institution Depositor account number Type of account ( = Savings, = Checking, = IRA (Deposit only, where state allows)) Non-US financial institution (International ACH transaction) 0,, 0 INDIVIDUAL

12 NMNRPY New Mexico Nonresident and Part-year Data General Information NMNRPY (0) NM First year resident (For use when both taxpayer and spouse have same residency status) Separate resident filing status: (This only affects the residency boxes on the Form PIT-) Taxpayer (F = First-Year Resident, N = Nonresident, P = Part-year Resident, R = Resident) Spouse (F = First-Year Resident, N = Nonresident, P = Part-year Resident, R = Resident) Dates of residency: Taxpayer Spouse (If dates differ from taxpayer's dates) Alternate tax calculation for nonresidents: From To Gross sales in or into New Mexico (Force)(Enter the total gross for all businesses) Elect to compute tax on gross royalty income (Nonresident only) Calculated gross royalties Gross royalties (Force) Nonresident military wages (Force) Nonresident military servicemember's spouse (T, S) Income qualifying for the military spouse exclusion 0 AGI Worksheet State Amounts Use Screen Alloc to enter the separate Rents / Royalties and Pass-through Entity amounts Schedule D (Force) Form (Force) Schedule E (Force) Net operating loss carryover (Enter as a positive number) Taxpayer 0 Spouse,, 0 INDIVIDUAL

13 NMChkl New Mexico Filing Checklists Form PIT-ES NMChkl (0) NM Name(s) and address are complete and legible Social security number(s) are legible Social security numbers, "Form PIT-ES", and the correct tax year written on check Correct tax year indicated on voucher(s) Correct quarter indicated on check for which payment is to be applied Form PIT-ES and check mailed to the appropriate address Check signed and dated Correct form is being used for estimated payments Form PIT-PV Correct form is being used for payment voucher Correct tax year indicated on voucher(s) Name(s) and address are complete and legible Social security number(s) are legible Social security numbers, "Form PIT-PV", and the correct tax year written on check Check included Form PIT-PV and check mailed to the appropriate address 0,, 0 INDIVIDUAL

14 NMAlloc New Mexico Income Allocation Commercial Domicile NMAlloc (0) NM Do NOT have a commercial domicile in New Mexico (Nonresidents only) Instate Income Amounts Schedule D (Force)(Residents only) Form (Force)(Residents only) Rents and royalties (Force) Pass-through income or loss (Force) Net operating loss carryover (Force)(Enter as a positive number),, 0 INDIVIDUAL

15 NMAppt EIN Business name New Mexico Income Apportionment General Information NMAppt (0) T, S, J State NM CRS identification number (0X-XXXXXX-00X) Business and Farm Income to be Apportioned Form PIT-B Income is apportioned 00% for New Mexico and 0% for all other states unless apportionment factors are entered below. For a nonresident with gross income under $00,000, no business activity other than sales, and no real estate or rental of real estate, the lower of Form PIT-B or Schedule CC tax is calculated. Force field for Schedule CC calculation on Screen NRPY, enter the gross income to calculate schedule or zero to force use of Form PIT-B Calculated Schedule CC gross income is New Mexico amount multiplied by the allocation ratio, if allocated by ratio at federal level. If allocated by amount, then ratio is calculated by dividing the net amount allocated by net income. Gross income Net income Allocation ratio Net amount allocated Calculated Apportionment Factors Total Everywhere New Mexico Property factor Payroll factor Sales factor Special method of apportionment - tax year ending date Date election became effective Special method elected Headquarters Operation Manufacturers Reporting class or type of allocated or apportioned income has changed from the prior year 0,, 0 INDIVIDUAL

16 NMCR New Mexico Non-refundable Credits Solar Market Development Tax Credit NMCR (0) NM Current year credit (Enter the Project number and certified credit amount received from the EMNRD) Carryover (Ten year carryover allowed - first year 00) Name of contact Phone number address Other Nonrefundable Non Carryover Credits Cancer clinical trial (Form RPD-) Electronic card reading equipment (Form RPD-) Other Nonrefundable Carryover Credits Credits will be applied in the order they are entered Other nonrefundable carryover credits (Select applicable code),, 0 INDIVIDUAL

17 NMPen New Mexico Penalties and Interest General Information NMPen (0) NM Date return filed (If other than due date of return) Suppress penalties on return: Underpayment of estimated tax ( = Suppress Form RPD- on the return, = Print Form RPD-, but suppress penalty on return) Late filing interest Failure to file and failure to pay Underpayment of Estimated Tax 0 tax 0 PIT--RC and working family tax credits Estimated payments not required until after / = Required to pay estimated payment after / but before / = Required to pay estimated payment after / but before / = Required to pay estimated payment after / Use the fields below to compute underpayment based on an alternate method Withholding as actually withheld: (Fourth quarter defaults to total withholdings less the first three quarters) First quarter (Force) Second quarter (Force) Third quarter (Force) 0 Waiver of Underpayment Penalty Explanation of waiver request (Required for waiver calculation) Amount (If not waiving entire underpayment penalty),, 0 INDIVIDUAL

18 NM New Mexico Electronic Filing Oil and Gas Withholdings NM (0) T, S EIN Payer's name Annual Statement of Withholding on Oil and Gas Proceeds Information entered on this screen is used for electronic filing purposes only. Enter oil and gas withholding on federal Screen A in the State and local income taxes statement. Enter, mineral withholding, in the Code field. Taxable year end date Payer: Indicate if social security number CRS identification number (0X-XXXXXX-00X) Street address City, state and zip code If foreign address: City Foreign province / county Foreign country code / name Foreign postal code 0 NM Gross oil and gas proceeds (If the income is zero or negative enter zero) New Mexico state tax withheld Recipient foreign address: City Foreign province / county Foreign country code / name Foreign postal code 0,, 0 INDIVIDUAL

19 NMNOL New Mexico Net Operating Loss Carryover Carryover Information Enter all amounts as POSITIVE numbers Starting with the oldest year first enter applicable data for each NOL. Do not enter data for expired or fully utilized NOLs. NMNOL (0) NM New Mexico Net Operating Loss: Loss year * Year NOL established * NOL incurred Utilized st year Utilized nd year Utilized rd year Utilized th year * A New Mexico NOL carryforward cannot be applied until the year following the loss or until the first tax year that begins after the date you filed a return establishing the loss. For example: the loss was incurred in 00, the return was not filed until 00; the loss year would be 00 and the established year would be 00. The first year the carryover could be utilized would be 0.,, 0 INDIVIDUAL

20 NMAmend New Mexico Amended Changes and Other Information Form PIT-Est Estimates Recalculated NMAmend (0) NM0 Do not recalculate estimated tax payments (Retain estimates as originally calculated) st payment nd payment rd payment th payment Originally calculated,, 0 INDIVIDUAL

21 NMELF New Mexico Electronic Filing NMELF (0) Electronic Filing Information Enter each preparer's Combined Reporting System identification number under Setup > System/Office Configuration > Preparers Consent to Disclose Information By using a computer system and software to prepare and transmit my client s return electronically, I consent to the disclosure of all information pertaining to my use of the system and software to create my client's return and to the electronic transmission of my client's tax return to the New Mexico Taxation and Revenue Department, as applicable by law. NM Suppress New Mexico electronic file when filing federal return electronically Form PIT- has already been signed and returned Signature date (If different from federal) Spouse signature date (If different from taxpayer signature date or federal Spouse signature date) ERO signature date (If different from taxpayer signature date or federal ERO signature date) Form RPD- is on file (Taxpayer Waiver for Preparers Electronic Filing Requirement) Print Form RPD-,, 0 INDIVIDUAL

22 NM New Mexico Electronic Filing PTE Withholding EIN Payer's name Annual Statement of Pass-Through Entity Withholding Information entered on this screen is used for electronic filing purposes only. Enter pass-through entity withholding on federal Screen K- Taxable year end date Payer: Indicate if social security number CRS identification number (0X-XXXXXX-00X) Street address City, state and zip code If foreign address: City Foreign country code / name Foreign province / county Foreign postal code 0 NM (0) Unit T, S NM Owner's New Mexico net income from PTE (If the income is zero or negative enter zero) New Mexico state tax withheld Recipient foreign address: City Foreign country code/name Foreign province / county Foreign postal code 0,, 0 INDIVIDUAL

23 NMT New Mexico Electronic Filing PTE KT Withholding EIN Payer's name Annual Statement of Pass-Through Entity Withholding K-T Information entered on this screen is used for electronic filing purposes only. Enter pass-through entity withholding on federal Screen KT- Taxable year end date Payer: Indicate if social security number CRS identification number (0X-XXXXXX-00X) Street address City, state and zip code If foreign address: City Foreign country code / name Foreign province / county Foreign postal code 0 NMT (0) Unit T, S NM Owner's New Mexico net income from PTE (If the income is zero or negative enter zero) New Mexico state tax withheld Recipient foreign address: City Foreign country code/name Foreign province / county Foreign postal code 0,, 0 INDIVIDUAL

24 NMeSign New Mexico Electronic Signature NMeSign (0) esignature - Suppression Enable esignature for a nominal per envelope fee at Setup > Office Configuration > esignature tab. UltraTax CS automatically generates an esignature envelope when any of the items listed below are being sent to the client. Use this section to suppress any of these items from being sent with the envelope for electronic signature. Form PIT-, New Mexico Individual Income Tax Declaration Bank Account Verification Worksheet esignature - Other NM Signer for joint returns (T, S, J) (Bank Account Verification),, 0 INDIVIDUAL

25 NM0 New Mexico Refund for Deceased Taxpayer General Information Enter information only if different from federal Screen 0 Person claiming refund ( = Personal representative, = Successor) Claimant's telephone number Name and address of personal representative or other person claiming refund: (Force) First and last name Social security number Street address and apartment number City, state, zip code NM0 (0) 0 NM,, 0 INDIVIDUAL

26 NMExt New Mexico Extension Extension Information NMExt (0) NM Calculate extension ( = Filed federal extension Form, = Filed New Mexico Form 0) Reason for extension Extended due date Extension payment actually made; reportable on main return Balance due on extension (Force) Additional payment Date Paid Amount,, 0 INDIVIDUAL

27 NMOthWH New Mexico Miscellaneous and Other Withholding Unit Income Description Form T, S, J Income and Withholding Information Enter state withholding in federal screens. Additional entries on this screen are used to complete withholding forms, required -D barcode data, and electronic filing records, if applicable. Not eligible for electronic file Alternate Form code Payer EIN Name Address City, state, zip code Foreign country code and name Foreign province or county Foreign postal code Telephone number Account number Corrected Void Income Federal income tax withheld State First state income and withholding Second state income and withholding Other form amounts: (Forms 0-M, 0-G, 0-DIV, 0-INT and 0-OID) Income Withholding NMOthWH (0) State ID Number NM Miscellaneous information: Tax year (Form 0-G) Foreign country and tax (Forms 0-INT and 0-DIV) Form 0-OID box 0 0,, 0 INDIVIDUAL

28 NM0B New Mexico 0B Unit Income Description Form T, S, J Income and Withholding Information Enter state withholding in federal screens. Additional entries on this screen are used to complete withholding forms, required -D barcode data, and electronic filing records, if applicable. Not eligible for electronic file Alternate Form code Payer EIN Name Address City, state, zip code Foreign country code and name Foreign province or county Foreign postal code Telephone number Account number Corrected Income Federal income tax withheld State Void Income First state income and withholding Second TIN notice received CUSIP number FATCA filing requirement Applicable box on Acquired description or date Sold or disposed description or date Proceeds description or amount Cost/Basis description or amount Accrued market discount Wash sale loss disallowed Type of gain or loss: Short term Long term Ordinary Basis reported to IRS Noncovered security Reported to IRS: Gross proceeds Net proceeds Loss not allowed Profit or loss realized on current year closed contracts Unrealized profit or loss on previous year open contracts Unrealized profit or loss on current year open contracts Aggregate profit or loss on contracts Proceeds from collectibles Bartering 0 Withholding State ID Number NM0B (0) 0 0 NM 0 0,, 0 INDIVIDUAL

29 NMYrN New Mexico Two Year Comparison for Nonresidents Income Allocation Enter amounts from 0 Form PIT- and Form PIT-B Total federal income Total New Mexico income Income allocation factor (xxx.xx) Tax and Credits NMYrN (0) NM0 Federal adjusted gross income Additions to federal income Federal standard or itemized deduction Federal exemptions Low and middle-income tax exemption Deductions and exemptions from federal income Medical care expense deduction (Form PIT-) Income tax before allocation Income tax after allocation Nonrefundable credits 0 Rebates, Refundable Credits, Payments, and Contributions Rebates and credits (Form PIT--RC) Income tax withheld Estimates Other payments (Extension, amended, PTE and O&G payments) Voluntary contributions Penalties and interest 0,, 0 INDIVIDUAL

30 NMPRRN New Mexico Preparer Review for Nonresidents Income Allocation NMPRRN (0) NM Total federal income (From Form PIT-B, line, column A) Total New Mexico income (From Form PIT-B, line, column B) Income allocation factor (xxx.xx) Tax and Credits Federal adjusted gross income Additions to federal income Federal standard or itemized deduction Federal exemptions Low and middle-income tax exemption Deductions and exemptions from federal income Medical care expenses deduction (Form PIT-) Income tax before allocation Income tax after allocation Nonrefundable credits Rebates, Refundable Credits, Payments and Contributions Rebates and refundable credits Income tax withheld Estimates Other payments (Extension, amended, PTE and O&G payments) Voluntary contributions 0,, 0 INDIVIDUAL

31 NMAddChg New Mexico Address Change General Information NMAddChg (0) NM Effective date Prior name(s) Taxpayer Spouse Daytime telephone number address Taxpayer's old mailing address: Address and apartment City, state, zip code Spouse's old mailing address: Address and apartment City, state, zip code Taxpayer's new mailing address: Address and apartment City, state, zip code Spouse's new mailing address: Address and apartment City, state, zip code Change of Address Data transfers from federal Screen 0 0,, 0 INDIVIDUAL