EFTA01222432.pdf

Computation of Recovery Exclusion 2019 For State Income Tax Deduction (Internal Revenue Code Section 111) • Keep for your records Name(s) Shown on Return Social Security Number 2018 State Income Tax Deduction and 2019 Recovery Amount 1 State income tax deduction from 2018 Schedule A, line 5 2 Is 2019 recovery amount (2018 state income tax refund amt.) known9 winYes No 3 If yes, enter 2018 state income tax refund received in 2019 (2019 recovery amount) If no, Part III is not completed. 2019 Recovery Exclusion 4 Recovery exclusion (amount deducted that did not reduce tax). From line column (i) of Pad IV.) You may exclude from your 2019 income any recovery of the 2018 state income tax deduction up to the amount on line 4. MEI 2018 Tax Benefit Amount (Applies only if 2019 recovery amount is known) 5 Tax benefit amount (amount of recovery that reduced tax). You must include in your 2019 income the amount on line 5 Recomputation of 2018 Tax Varying Deduction for State Income Tax (a) (b) Resulting Amounts Are (h) Tentative No. Using (c) (d) (e) (f) (9) flt (l) State Alternative Tax Exclusion Tax Income State and Regular Minimum Total Total Change Amount Benefit Tax Local Tax Tax Tax plus Tax Tax Amount Amount Deduction Deduction Excess Before After Adv Prem Credits Credits Tax Credit EFTA01222432