EFTA01220507.pdf

Computation of Recovery Exclusion 2015 For State Income Tax Deduction (Internal Revenue Code Section 111) ► Keep for your records Name(s) Shown on Return Social Security Number 2014 State Income Tax Deduction and 2015 Recovery Amount 1 State income tax deduction from 2014 Schedule A, line 5 2 Is 2015 recovery amount (2014 state income tax refund amt.) known-) Yes n No 3 If yes, enter 2014 state income tax refund received in 2015 (2015 recovery amount) If no, Part Ill is not completed. 2015 Recovery Exclusion 4 Recovery exclusion (amount deducted that did not reduce tax). From line column (h) of Part IV.) You may exclude from your 2015 income any recovery of the 2014 state income tax deduction up to the amount on line 4. Part III 2014 Tax Benefit Amount (Applies only if 2015 recovery amount is known) 5 Tax benefit amount (amount of recovery that reduced tax). You must include in your 2015 income the amount on line 5. Recomputatlon of 2014 Tax Varying Deduction for State income Tax (a) (b) Resulting Amounts Are (h) Tentative No. Using Tax State (c) (d) (e) (f) (g) Change (I) (I) Income State and Alternative Total Total Amount Exclusion Tax Tax Local Tax Regular Minimum Tax Tax Amount Benefit Deduction Deduction Tax Tax Before After Amount Credits Credits O EFTA01220507