| STEP 1 NAME
AND ADDRESS |
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| STEP 2 FILING
STATUS |
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| STEP 3 EXEMPTION
CREDITS |
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STEP 4 GROSS INCOME
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Wages, Salaries, Tips, Etc. |
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Taxable Interest Income |
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Dividend Income |
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Alimony Received |
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Business Income (Loss) from Schedule C
or C-EZ |
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Capital Gain (Loss) |
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Other Gains (Losses) |
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Taxable IRA Distributions |
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Taxable Pensions and Annuities |
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Rents, Royalties, Partnerships,
Estates, Trusts, Etc. |
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Farm Income (Loss) |
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Unemployment Compensation |
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Taxable Social Security Benefits |
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Other Income |
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Gross Income Total |
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STEP 5 ADJUSTMENTS TO INCOME
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Payments to an IRA, Keogh Plan or SEP |
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One-Half of Self-Employment Tax |
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Health Insurance Deduction |
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Penalty of Early Withdrawal of Savings |
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Alimony Paid |
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Pension/Retirement Income Exclusion |
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Moving Expense Deduction |
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Iowa Capital Gains Deduction |
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Other Adjustments |
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Total Adjustments |
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Net Income and Qualifications for Exemption |
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STEP 6 FEDERAL TAX ADDITION AND
DEDUCTION
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Federal Income Tax Refund Received in
2004 |
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Self-Employment/Household Employment Taxes |
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Addition for Federal Taxes |
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Total |
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Federal Tax Withheld |
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Federal Estimated Tax Payments Made in
2004 |
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Additional Federal Tax Paid in 2004 |
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Deduction for Federal Taxes |
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Balance |
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STEP 7 ITEMIZED OR STANDARD DEDUCTION
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Balance |
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Total Itemized Deductions from Schedule
A |
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Iowa Income Tax |
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Balance |
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Other Deductions |
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Itemized or Standard Deduction |
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Taxable Income |
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| STEP 8 TAX CALCULATION |
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Tax or Alternate Tax |
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Iowa Lump-Sum Tax |
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Iowa Minimum Tax |
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Total Tax |
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Total Exemption Credits |
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Iowa Earned Income Credit |
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Tuition and Textbook Credit (K-12 only) |
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Total Credits |
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Balance and Tax Reduction Worksheet |
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Credit for Nonresident or Part-Year Resident |
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Balance |
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Other Iowa Credits |
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Balance |
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School District Surtax/Emergency Medical
Services Surtax |
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Total Tax |
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Total Tax Before Contributions |
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Contributions: Chickadee, Corn Dog, Keep
Iowa Beautiful, Firefighters |
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Total Tax and Contributions |
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STEP 9 CREDITS
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Iowa Income Tax Withheld |
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Estimate and Voucher Payments |
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Out-of-State Credit |
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Motor Vehicle Fuel Tax Credit |
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Child and Dependent Care Credit |
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Other Refundable Credits |
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Total |
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Total Credits |
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| STEP 10 REFUND OR AMOUNT YOU OWE |
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Amount You Overpaid |
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Amount to be Refunded |
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Overpayment Applied to Estimated Tax |
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Amount of Tax You Owe |
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Penalty for Underpayment of Estimated
Tax |
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How to calculate 2210
penalty |
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Penalty and Interest |
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Total Amount Due |
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