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District of Columbia Free Printable  for 2020 District of Columbia Disability Income Exclusion

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Disability Income Exclusion
Form D-2440

Clear Print Government of the District of Columbia 2019 D-2440 Disability Income Exclusion *192400110002* This is a FILL-IN format. Please do not handwrite any data on this form other than your signature. OFFICIAL USE ONLY Vendor ID#0002 Taxpayer identification number (TIN) Name as shown on Form D-40 Personal information Date of your birth (MMDDYYYY) Date you retired (MMDDYYYY) Date of spouse’s/registered domestic Date retired (MMDDYYYY) partner’s birth(MMDDYYYY) Name of your employer Payor, if other than employer Name of employer Payor, if other than employer Have you filed a physician’s certification for this disability in previous years? Yes No If yes, do not file another certification. If no, you must file the physician’s certification provided below. Income If married or registered domestic partners, use both columns. Round cents to nearest dollar. If amount is zero, leave line blank. You 1 Total amount of disability payments received in 2019 1 $ 2 Multiply $100 by the number of weeks you received 2 $ .00 $ .00 $ 3 $ .00 $ disability payments in 2019. If you received pay for part of a week, see Line 2 instructions on the back. 3 Enter Line 1 or Line 2 amount, whichever is less. 4 Add the amounts for you and your spouse/registered domestic partner from Line 3. 4 $ Your spouse/registered domestic partner .00 .00 .00 Total income .00 Limitation on exclusion 5 Federal adjusted gross income from Form D-40, Line 4. $ $ $ Fill in if loss 5 6 Taxable social security income from Form D-40, Line 10. 6 7 Subtract Line 6 from Line 5. 7 8 Amount used to reduce the excludable disability income. 9 Subtract Line 8 from Line 7. If zero or a negative number, stop here. Do not file this form. 10  Disability income payment excludable. Subtract Line 9 from Line 4. 9 $ 10 $ .00 .00 .00 – 1 5 0 0 0 .00 .00 .00 Enter on D-40 Schedule I, Calculation B, Line 2 (see D-40 instructions). The exclusion may not exceed $5200 per disabled person. Government of the District of Columbia 2019 Physician’s Certification of Permanent and Total Disability Name of disabled taxpayer Taxpayer identification number (TIN) MM DD I certify that the above taxpayer was permanently and totally disabled when the taxpayer retired. (Enter retirement date.) Physician’s first name, middle initial, last name Physician’s address (number and street) Suite number City State Physician’s phone number Physician’s signature Attach to Form D-40. See instructions on back. Revised 08/2019 Zip Code + 4 Date YYYY D-2440 PAGE 2 *192400120002* Enter your last name Enter your TIN Government of the District of Columbia 2019 Physician’s Certification of Permanent and Total Disability Name of disabled taxpayer Taxpayer identification number (TIN) MM DD YYYY I certify that the above taxpayer was permanently and totally disabled when the taxpayer retired. (Enter retirement date.) Physician’s first name, middle initial, last name Physician’s address (number and street) City State Physician’s phone number Suite number Zip Code + 4 Physician’s signature Date What is the purpose of Form D-2440? Form D-2440 is used to determine the amount of disability income you may exclude from the federal adjusted gross income you report on DC Form D-40. Enter the amount from Line 10 of this form on Line 2 of Calculation B of Schedule I. The maximum annual exclusion per disabled person is $5,200. Line 2 If you received disability payments for part of a week, follow the example below to determine the exclusion for that portion: Who may file a Form D-2440? You must meet all of the following requirements: Example: $100 divided by 5 days (number of days in typical work week) = $20. $20 x 3 (number of days you were paid for partial week) = $60. Add this amount to the total amount you were paid for the full weeks. • If you are married or registered domestic partners, you are filing a joint return; • You received disability payments during 2019; • You were under the age of 65 on December 31, 2019; • You retired on disability and were permanently and totally disabled when you retired; • On January 1, 2019, you had not reached the age required to retire under your employer’s retirement program; and Divide $100 by the number of days in a week you normally worked before you retired and multiply the result by the number of days you were paid for the partial week. Line 5 Federal adjusted gross income from Form D-40, Line 4. If the amount on this line is minus, fill in the oval. Line 8 Amount used to reduce disability income $15,000 is the amount DC uses to reduce the disability income you can exclude. • You have not notified the Office of Tax and Revenue that you have chosen to treat the disability income as a pension. Line 10 Disability income exclusion This is the amount you may use to reduce your DC taxable income. $5,200 is the maximum annual amount per disabled person that may be excluded. Personal information Physician’s certification If you are filing a joint return, please provide the information requested for you and your spouse/registered domestic partner, even if your spouse/registered domestic partner is not disabled and is not claiming a disability exclusion. To claim an exclusion, your physician must certify that you are, according to the definition below, permanently disabled. If both you and your spouse/registered domestic partner are claiming the exclusion, each must file a certification. You do not have to file another certification if you have filed one in a previous year. Attach the certification(s) to your Form D-40. Income and Limitation on Exclusion Line 1 Total amount of disability payments received in 2019. Enter the total amount of disability payments you received in 2019. Do not include any lump-sum payment received for accrued annual leave when you retired on disability. (The annual leave payment is included in your gross income for the year of receipt.) Payments from a retirement plan or profit-sharing plan that does not have a provision for disability retirement do not qualify for the exclusion. Revised 08/2019 Instruction for the Physician Date taxpayer retired Please certify that the taxpayer ceased active employment because of his or her permanent disability and retired on the date that he or she became disabled. Definition of permanent and total disability Permanent and total disability means that the taxpayer is unable to engage in any substantial gainful activity because of a physical or mental condition and this condition has lasted continuously for at least a year, will last continuously for at least a year, or is fatal.
Extracted from PDF file 2019-district-of-columbia-form-d-2440.pdf, last modified September 2019

More about the District of Columbia Form D-2440 Individual Income Tax TY 2019

We last updated the Disability Income Exclusion in February 2020, so this is the latest version of Form D-2440, fully updated for tax year 2019. You can download or print current or past-year PDFs of Form D-2440 directly from TaxFormFinder. You can print other District of Columbia tax forms here.


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Other District of Columbia Individual Income Tax Forms:

TaxFormFinder has an additional nineteen District of Columbia income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form D-40B Nonresident Request for Refund
Form DR 0104 Individual Income Tax Return and Instructions Booklet
D-40WH Withholding Tax Schedule
D-40P Payment Voucher
FR-147 Statement of Person Claiming Refund Due a Deceased Taxpayer

Download all DC tax forms View all 20 District of Columbia Income Tax Forms


Form Sources:

District of Columbia usually releases forms for the current tax year between January and April. We last updated District of Columbia Form D-2440 from the Office of Taxpayer Revenue in February 2020.

Show Sources >

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of District of Columbia Form D-2440

We have a total of seven past-year versions of Form D-2440 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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