Louisiana Free Printable  for 2017 Louisiana Nonresident Income Tax Return

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Nonresident Income Tax Return
Form IT-540B

LOUISIANA FILE ONLINE Fast. Easy. Absolutely Free. revenue.louisiana.gov/fileonline Are you due a refund? If you file this paper return, it will take 12 to 16 weeks to get your refund check. With Louisiana File Online and direct deposit, you can receive your refund within 60 days. 2016 LOUISIANA NONRESIDENT AND PART-YEAR RESIDENT IT-540B WEB (Page 1 of 4) Mark Box: Name Change Decedent Filing IMPORTANT! You must enter your SSN below in the same order as shown on your federal return. Your legal first name Init. Last name Suffix If joint return, spouse’s name Init. Last name Suffix Your SSN Spouse’s SSN Present home address (number and street including apartment number or rural route) Spouse Decedent City, Town, or APO Address Change State ZIP Area code and daytime telephone number Amended Return NOL Carryback Your Date of Birth Spouse’s Date of Birth FILING STATUS: Enter the appropriate number in the filing status box. It must agree with your federal return. 6 EXEMPTIONS: 6A Enter a “1” in box if single. X Yourself 65 or older Blind Spouse 65 or older Blind Enter a “2” in box if married filing jointly. 6B Enter a “3” in box if married filing separately. Total of 6A & 6B Enter a “4” in box if head of household. If the qualifying person is not your dependent, enter name here. Enter a “5” in box if qualifying widow(er). 6C DEPENDENTS – Enter dependent information below. If you have more than 6 dependents, attach a statement to your return with the required information. Enter the total number from Federal Form 1040A, Line 6c, or Federal Form 1040, Line 6c, in the boxes here. First Name Last Name Social Security Number Relationship to you 6C Birth Date (mm/dd/yyyy) IMPORTANT! All four (4) pages of this return MUST be mailed in together along with your W-2s and completed schedules. Please paperclip. Do not staple. 6D TOTAL EXEMPTIONS – Total of 6A, 6B, and 6C 6D FOR OFFICE USE ONLY Field Flag WEB 61765 IT-540B WEB (Page 2 of 4) Enter your Social Security Number. If you are not required to file a federal return, indicate wages here. Mark this box and enter zero “0” on Line 23. 7 FEDERAL ADJUSTED GROSS INCOME – Enter the amount of your Federal Adjusted Gross Income from the NPR worksheet, Federal column, Line 12. 7 8 LOUISIANA ADJUSTED GROSS INCOME – Enter the amount of your Louisiana Adjusted Gross Income from the NPR worksheet, Louisiana column, Line 33. 8 9 RATIO OF LOUISIANA ADJUSTED GROSS INCOME TO FEDERAL ADJUSTED GROSS INCOME – Divide Line 8 by Line 7. Carry out to two decimal places in the percentage. DO NOT ROUND UP. The percentage cannot exceed 100%. 9 REFUNDABLE TAX CREDITS If you did not itemize your deductions on your federal return, leave Lines 10A, 10B, and 10C blank and go to Line 10D. 10A FEDERAL ITEMIZED DEDUCTIONS 10A 10B FEDERAL STANDARD DEDUCTION 10B 10C EXCESS FEDERAL ITEMIZED DEDUCTIONS – Subtract Line 10B from Line 10A. 10C 10D FEDERAL INCOME TAX – If your federal income tax has been decreased by a federal disaster credit allowed by IRS, mark the box. See instructions for Schedule H-NR. 10D 10E TOTAL DEDUCTIONS – Add Lines 10C and 10D. 10E 10F ALLOWABLE DEDUCTIONS – Multiply Line 10E by the percentage on Line 9. Round to the nearest dollar. 10F 11 LOUISIANA NET INCOME – Subtract Line 10F from Line 8. If less than zero, enter “0.” 11 12 YOUR LOUISIANA INCOME TAX – See the Tax Computation Worksheet to calculate the amount of your Louisiana income tax. 12 13 OTHER NONREFUNDABLE PRIORITY 1 CREDITS – From Schedule C-NR, Line 8 14 TAX LIABILITY AFTER NONREFUNDABLE PRIORITY 1 CREDITS – Subtract Line 13 from Line 12. 15 2016 LOUISIANA REFUNDABLE CHILD CARE CREDIT – Your Federal Adjusted Gross Income must be EQUAL TO OR LESS THAN $25,000 to claim the credit on this line. See instructions, page 12 and Refundable Care Credit Worksheet. 13 14 15 15A Enter the qualified expense amount from the Refundable Child Care Credit Worksheet, Line 3. 15A 15B Enter the amount from the Refundable Child Care Credit Worksheet, Line 6. 15B 16 2016 LOUISIANA REFUNDABLE SCHOOL READINESS CREDIT - Your Federal Adjusted Gross Income must be EQUAL TO OR LESS THAN $25,000 to claim the credit on this line. See Refundable School Readiness Credit Worksheet. 16 5 4 3 2 17 17 LOUISIANA CITIZENS INSURANCE CREDIT See instructions, page 2. 18 OTHER REFUNDABLE PRIORITY 2 CREDITS – From Schedule F-NR, Line 10 18 19 TOTAL REFUNDABLE PRIORITY 2 CREDITS – Add Lines 15, 16 through 18. Do not include amounts on Lines 15A, 15B and 17A. 19 20 TAX LIABILITY AFTER REFUNDABLE PRIORITY 2 CREDITS – See instructions, page 2. 20 21 OVERPAYMENT AFTER REFUNDABLE PRIORITY 2 CREDITS – See instructions, page 2. Enter the first 4 characters of your last name in these boxes. 17A 21 CONTINUE ON NEXT PAGE WEB 61766 IT-540B WEB (Page 3 of 4) PAYMENTS Enter your Social Security Number. 22 NONREFUNDABLE PRIORITY 3 CREDITS – From Schedule J-NR, Line 16 22 23 ADJUSTED LOUISIANA INCOME TAX – Subtract Line 22 from Line 20. If the result is less than zero, or you are not required to file a federal return, enter zero “0.” 23 24A CONSUMER USE TAX for purchases before April 1, 2016 No use tax due. 24A 24B CONSUMER USE TAX for purchases on or after April 1, 2016 Amount from the Consumer Use Tax Worksheet. 24B 25 25 TOTAL INCOME TAX AND CONSUMER USE TAX- Add Lines 23, 24A and 24B. 26 OVERPAYMENT OF REFUNDABLE PRIORITY 2 CREDITS – Enter the amount from Line 21. 27 REFUNDABLE PRIORITY 4 CREDITS – From Schedule I-NR, Line 6 28 AMOUNT OF LOUISIANA TAX WITHHELD FOR 2016 – Attach Forms W-2 and 1099. 28 29 AMOUNT OF CREDIT CARRIED FORWARD FROM 2015 29 30 AMOUNT PAID ON YOUR BEHALF BY A COMPOSITE PARTNERSHIP FILING Enter name of partnership. 30 31 AMOUNT OF ESTIMATED PAYMENTS FOR 2016 31 32 AMOUNT PAID WITH EXTENSION REQUEST 32 33 TOTAL REFUNDABLE TAX CREDITS AND PAYMENTS – Add Lines 26 through 32. 33 34 OVERPAYMENT – If Line 33 is greater than Line 25, subtract Line 25 from Line 33. Your overpayment may be reduced by Underpayment of Estimated Tax Penalty. Otherwise, go to Line 41. 34 35 UNDERPAYMENT PENALTY – See instructions for Underpayment Penalty, page 11, and Form R-210NR. If you are a farmer, check the box. 35 36 ADJUSTED OVERPAYMENT – If Line 34 is greater than Line 35, subtract Line 35 from Line 34. If Line 35 is greater than Line 34, subtract Line 34 from Line 35, and enter the balance on Line 41. 36 37 TOTAL DONATIONS – From Schedule D-NR, Line 24 37 38 SUBTOTAL – Subtract Line 37 from Line 36. This amount of overpayment is available for credit or refund. 38 39 AMOUNT OF LINE 38 TO BE CREDITED TO 2017 INCOME TAX 26 27 CREDIT 39 REFUND DUE AMOUNT TO BE REFUNDED – Subtract Line 39 from Line 38. If mailing to LDR, use Address 2 on the next page. 40 Enter a “2” in box if you want to receive your refund by paper check. Enter a “3” in box if you want to receive your refund by direct deposit. Complete information below. If information is unreadable, you are filing for the first time, or if you do not make a refund selection, you will receive your refund by paper check. 40 REFUND DIRECT DEPOSIT INFORMATION Type: Checking Savings Routing Number Will this refund be forwarded to a financial institution located outside the United States? Yes No Account Number Enter the first 4 characters of your last name in these boxes. COMPLETE AND SIGN RETURN ON NEXT PAGE WEB 61767 IT-540B WEB (Page 4 of 4) AMOUNTS DUE LOUISIANA Enter your Social Security Number. 41 AMOUNT YOU OWE – If Line 25 is greater than Line 33, subtract Line 33 from Line 25. 41 42 ADDITIONAL DONATION TO THE MILITARY FAMILY ASSISTANCE FUND 42 43 ADDITIONAL DONATION TO THE COASTAL PROTECTION AND RESTORATION FUND 43 44 ADDITIONAL DONATION TO LOUISIANA FOOD BANK ASSOCIATION 44 45 INTEREST – From the Interest Calculation Worksheet, page 11, Line 5. 45 46 DELINQUENT FILING PENALTY – From the Delinquent Filing Penalty Calculation Worksheet, page 11, Line 7. 46 47 DELINQUENT PAYMENT PENALTY – From Delinquent Payment Penalty Calculation Worksheet, page 11, Line 7. 47 48 UNDERPAYMENT PENALTY – See instructions for Underpayment Penalty, page 11, and Form R-210NR. If you are a farmer, check the box. 48 49 BALANCE DUE LOUISIANA – Add Lines 41 through 48. If mailing to LDR, use address 1 below. For electronic payment options, see inside cover. 49 PAY THIS AMOUNT. DO NOT SEND CASH. IMPORTANT ! All four (4) pages of this return MUST be mailed in together along with your W-2s and completed schedules. Please paperclip. Do not staple. I declare that I have examined this return, and to the best of my knowledge, it is true and complete. Declaration of paid preparer is based on all available information. If I made a contribution to the START Savings Program, I consent that my Social Security Number may be given to the Louisiana Office of Student Financial Assistance to properly identify the START Savings Program account holder. If married filing jointly, both Social Security Numbers may be submitted. I understand that by submitting this form I authorize the disbursement of individual income tax refunds through the method as described on Line 40. Your Signature Date Signature of paid preparer other than taxpayer Spouse’s Signature (If filing jointly, both must sign.) Date Telephone number of paid preparer ( ) Date Enter the first 4 characters of your last name in these boxes. Individual Income Tax Return Calendar year return due 5/15/2017 { Ad dr e s s} Social Security Number, PTIN, or FEIN of paid preparer 1 2 Mail Balance Due Return with Payment TO: Department of Revenue P. O. Box 3550 Baton Rouge, LA 70821-3550 Mail All Other Individual Income Tax Returns TO: Department of Revenue P. O. Box 3440 Baton Rouge, LA 70821-3440 SPEC CODE WEB 61768 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. Nonresident and Part-Year Resident (NPR) Worksheet See instructions for completing the NPR worksheet beginning on page 3. 1 Wages, salaries, tips, etc. 2 Taxable interest 3 Dividends 4 Business income (or loss) and Farm income (or loss) 5 Gains (or losses) 6 IRA distributions, Pensions and Annuities. 7 Rental real estate, royalties, partnerships, S corporations, trusts, etc. 8 Social Security benefits 9 Other income 10 Total Income – Add the income amounts on Lines 1 – 9 for each column. 11 Total Adjustments to Income 12 Adjusted Gross Income – Subtract Line 11 from Line 10 for each column. Enter the amount in the Federal column on IT-540B, Line 7. The amount shown in the Federal column should agree with Federal Form 1040EZ, Line 4, OR Federal Form 1040A, Line 21, OR Federal Form 1040, Line 37. Federal Louisiana Subtractions Additions 2016 Adjustments to Income 13 Interest and dividend income from other states and their political subdivisions 14 Recapture of START contributions 15 Total – Add Lines 12, 13, and 14. 16 Interest and Dividends on U.S. Government Obligations 17 Louisiana State Employees’ Retirement Benefits – Taxpayer date retired: ____________________ Spouse date retired: ____________________ 18 Louisiana State Teachers’ Retirement Benefits – Taxpayer date retired: ____________________ Spouse date retired: ___________________ 19 Federal Retirement Benefits – Date retired: Taxpayer ____________ Spouse: _____________ 20 Other Retirement Benefits – Date retired: Taxpayer _____________ Spouse: _____________ Provide name or statute: _______________________________________________________________ 21 Annual Retirement Income Exemption for Taxpayers 65 or over – Provide name of pension or annuity: ___________________________________________________ 22 Native American Income 23 START Savings Program Contribution 24 Military Pay Exclusion 25 Road Home 26 Recreation Volunteer or Volunteer Firefighter 27 Voluntary Retrofit Residential Structure 28 IRC 280C Expense Adjustment 29 Elementary and Secondary School Tuition, Educational Expenses for Home-Schooled Children, Educational Expenses for Quality Public Education 30 Capital Gain from Sale of Louisiana Business 31 Other Exempt Income Identify: ____________________________________________________________________________ 32 Total Exempt Income – Add Lines 16 through 31. 33 LOUISIANA ADJUSTED GROSS INCOME. Subtract Line 32 from Line 15. Also, enter this amount on Form IT-540B, Line 8. WEB 61769 ATTACH TO RETURN IF COMPLETED. 2016 Louisiana School Expense Deduction Worksheet Your Name I. II. Your Social Security Number This worksheet should be used to calculate the three School Expense Deductions listed below. These deductions may only be taken for school expense paid in Louisiana during the time a person was a Louisiana resident. Refer to Revenue Information Bulletin 12-008 and 09-019 on LDR’s website. 1. Elementary and Secondary School Tuition – R.S. 47:297.10 provides a deduction for amounts paid during the tax year for tuition and fees required for your dependent child’s enrollment in a nonpublic elementary or secondary school that complies with the criteria set forth in Brumfield v. Dodd and Section 501(c)(3) of the Internal Revenue Code or to any public elementary or secondary laboratory school that is operated by a public college or university. The school can verify that it complies with the criteria. The deduction is equal to the actual amount of tuition and fees paid per dependent, limited to $5,000. The tuition and fees that can be deducted include amounts paid for tuition, fees, uniforms, textbooks and other supplies required by the school. 2. Educational Expenses for Home-Schooled Children – R.S. 47:297.11 provides a deduction for educational expenses paid during the tax year for home-schooling your dependent child. In order to qualify for the deduction, you must be approved by the State Board of Elementary and Secondary Education (BESE) for home-schooling. The deduction is equal to 50 percent of the actual qualified educational expenses paid for the home-schooling per dependent, limited to $5,000. Qualified educational expenses include amounts paid for the purchase of textbooks and curricula necessary for home-schooling. 3. Educational Expenses for a Quality Public Education – R.S. 47:297.12 provides a deduction for the fees or other amounts paid during the tax year for a quality education of a dependent child enrolled in a public elementary or secondary school, including Louisiana Department of Education approved charter schools. The deduction is equal to 50 percent of the amounts paid per dependent, limited to $5,000. The amounts that can be deducted include amounts paid for uniforms, textbooks and other supplies required by the school. On the chart below, list the name of each student and the name of the school the student attends. If the student is home-schooled, enter “homeschooled.” Enter an “X” in the box in column 1 if your dependent qualifies for the Elementary and Secondary School Tuition deduction, column 2 for Educational Expenses for Home-Schooled Children deduction, or column 3 for Quality Public Education deduction. If you have more than six qualifying dependents, attach a statement to your return with the required information. Student Name of Qualifying Dependent Deduction as described in Section I Name of School 1 2 3 A B C D E F III. Using the letters that correspond to each qualifying dependent listed in Section II, list the amount paid per student for each qualifying expense. For students attending a qualifying school, the expense must be for an item required by the school. Refer to the information in Section I to determine which expenses qualify for the deduction. Retain copies of cancelled checks, receipts and other documentation in order to support the amount of qualifying expenses. If you checked column 1 in Section II, skip the 50% calculation below; however, the deduction is still limited to $5,000. Qualifying Expense A List the amount paid for each student as listed in Section II. B C D E F Tuition and Fees School Uniforms Textbooks, or Other Instructional Materials Supplies Total (add amounts in each column) If column 2 or 3 in Section II was checked, multiply by: 50% 50% 50% 50% 50% 50% Deduction per Student – Enter the result or $5,000 whichever is less. IV. Total the Deduction per Student in Section III, based on the deduction for which the students qualified as marked in boxes 1, 2, or 3 in Section II. Enter the total Elementary and Secondary School Tuition Deduction. $ Enter the total Educational Expenses for Home-Schooled Children Deduction. $ Enter the total Educational Expenses for a Quality Public Education Deduction. $ Enter the total deduction here and on the Nonresident and Part-year Resident (NPR) Worksheet, Line 29. $ WEB 61756 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. SCHEDULE C-NR – 2016 NONREFUNDABLE PRIORITY 1 CREDITS 1 CREDIT FOR CERTAIN DISABILITIES - Mark an “X” in the appropriate boxes. Only one credit is allowed per person. See instructions on page 5 for definitions of these disabilities. Deaf 2 3 Loss of Limb 1A Yourself 1B Spouse 1C Dependent * List dependent names here.  Mentally incapacitated Blind 1D Enter the total number of qualifying individuals. Only one credit is allowed per person. 1D 1E Multiply Line 1D by $72. 1E * CREDIT FOR CONTRIBUTIONS TO EDUCATIONAL INSTITUTIONS 2A Enter the value of computer or other technological equipment donated. Attach Form R-3400. 2A 2B Multiply Line 2A by 29 percent. 2B CREDIT FOR CERTAIN FEDERAL TAX CREDITS 3A Enter the amount of eligible federal credits. 3B Multiply Line 3A by 7.2 percent. Enter the result or $18, whichever is less. This credit is limited to $18. 3A 3B Additional Nonrefundable Priority 1 Credits Enter credit description and associated code, along with the dollar amount of credit claimed. See instructions beginning on page 5. Credit Description Credit Code Amount of Credit Claimed 4 4 5 5 6 6 7 7 8 TOTAL NONREFUNDABLE PRIORITY 1 CREDITS – Add Lines 1E, 2B, 3B, and 4 through 7. Also, enter this amount on Form IT-540B, Line 13. Description Code Description Code Premium Tax 100 Bone Marrow 120 Commercial Fishing 105 Law Enforcement Education 125 Family Responsibility 110 First Time Drug Offenders Small Town Doctor/Dentist 115 Bulletproof Vest Description 8 Code Description Code 140 Debt Issuance 155 130 Nonviolent Offenders Owner of Newly Constructed Accessible Home 145 Donations of Materials, Equipment, Advisors, Instructors 175 135 Qualified Playgrounds 150 Other 199 WEB 61770 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. SCHEDULE D-NR – 2016 DONATION SCHEDULE 1 1 Adjusted Overpayment- From IT-540B, Line 36 2 The Military Family Assistance Fund 2 13 The Louisiana Youth Leadership Seminar Corporation 13 3 Coastal Protection and Restoration Fund 3 14 Lighthouse for the Blind in New Orleans 14 4 The START Program 4 15 The Louisiana Association for the Blind 15 5 Wildlife Habitat and Natural Heritage Trust Fund 5 16 Louisiana Center for the Blind 16 6 Louisiana Cancer Trust fund 6 17 Affiliated Blind of Louisiana, Inc. 17 7 Louisiana Animal Welfare Commission 7 18 Louisiana State Troopers Charities, Inc. 18 8 Louisiana Food Bank Association 8 19 Friends of Palmetto State Park 19 9 Make-A-Wish Foundation of the Texas Gulf Coast and Louisiana 9 20 The American Rose Society 20 10 Louisiana Association of United Ways/LA 2-1-1 10 21 The Extra Mile 21 11 American Red Cross 11 22 Louisiana Naval War Memorial Commission 22 12 Louisiana National Guard Honor Guard for Military Funerals 12 23 Children’s Therapeutic Services at the Emerge Center 23 24 TOTAL DONATIONS – Add Lines 2 through 23, This amount cannot be more than Line 1. Also, enter this amount on Form IT-540B, Line 37. DONATIONS OF LINE 1 DONATIONS OF LINE 1 Individuals who file an individual income tax return and have overpaid their tax may choose to donate all or part of their overpayment shown on Line 36 of Form IT-540B to the organizations or funds listed below. Enter on Lines 2 through 23, the portion of the overpayment you wish to donate. The total on Line 24 cannot exceed the amount of your overpayment on Line 36 of Form IT-540B. 24 WEB 61771 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. SCHEDULE F-NR – 2016 REFUNDABLE PRIORITY 2 CREDITS 1 Credit for amounts paid by certain military servicemembers for obtaining Louisiana Hunting and Fishing Licenses. 1A Yourself Date of Birth (MM/DD/YYYY) _________________ Driver’s License number ________________________________ State of issue _______ 1B Spouse Date of Birth (MM/DD/YYYY) _________________ or State Identification ________________________________ Driver’s License number ________________________________ State of issue _______ State of issue _______ or State Identification State of issue _______ 1C ________________________________ Dependents: List dependent names. Dependent name __________________________________________________________________ Date of Birth (MM/DD/YYYY) ________________________ Dependent name __________________________________________________________________ Date of Birth (MM/DD/YYYY) ________________________ Dependent name __________________________________________________________________ Date of Birth (MM/DD/YYYY) ________________________ Dependent name __________________________________________________________________ Date of Birth (MM/DD/YYYY) ________________________ 1D Enter the amount of the credit for fees paid by certain military service members for obtaining Louisiana Hunting and Fishing Licenses. See instructions, page 7. 1D Additional Refundable Priority 2 Credits Enter credit description and associated code, along with the dollar amount of credit claimed. See instructions beginning on page 7. Credit Description Credit Code Amount of Credit Claimed 2 2 3 3 4 4 5 5 6 6 Transferable, Refundable Priority 2 Credits Enter the State Certification Number from Form R-6135, along with the dollar amount of credit claimed. See instructions beginning on page 7. Credit Description Credit Code Amount of Credit Claimed 6 2 F 7 Musical and Theatrical Production 6 2 F 8 Musical and Theatrical Production 6 2 F 7. Musical and Theatrical Production 7A. 8. 8A. 9. 9 9A. 10. OTHER REFUNDABLE PRIORITY 2 CREDITS – Add Lines 1D and 2 through 9. Also enter this amount on Form IT-540B, Line 18. 10 SEE CREDIT CODES ON NEXT PAGE WEB 61772 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. SCHEDULE F-NR – 2016 REFUNDABLE PRIORITY 2 CREDITS ...CONTINUED Description Code Ad Valorem Offshore Vessels Telephone Company Property Prison Industry Enhancement Urban Revitalization 52F 54F 55F 56F Mentor-Protégé Milk Producers 57F 58F Description Code Technology Commercialization 59F Historic Residential 60F Angel Investor 61F School Readiness Child Care Provider 65F Description Code Description School Readiness Child Care Directors and Staff 66F Retention and Modernization School Readiness Business – Supported Child Care 67F School Readiness Fees and Grants to Resource and Referral Agencies 68F Conversion of Vehicle to Alternative Fuel Digital Interactive Media & Software Code 70F 71F 73F Solar Energy Systems – Leased 74F Other Refundable Credit 80F *** Schedule G – NR omitted on purpose *** SCHEDULE H-NR – 2016 MODIFIED FEDERAL INCOME TAX DEDUCTION 1 Enter the amount of your federal income tax liability as shown on the Federal Income Tax Deduction Worksheet, page 2. 1 2 Enter the amount of federal disaster credits allowed by IRS. 2 3 Add Line 1 and Line 2. Also, enter this amount on Form IT-540B, Line 9, and mark the box on Line 9 to indicate that your income tax deduction has been increased. 3 SCHEDULE I-NR – 2016 REFUNDABLE PRIORITY 4 CREDITS Enter credit description and associated code, along with the dollar amount of credit amount claimed. See instructions beginning on page 8. Credit Description Credit Code Amount of Credit Claimed 1 1 2 2 3 3 4 4 5 5 6 TOTAL REFUNDABLE PRIORITY 4 CREDITS – Add Lines 1 through 5. Also, enter this amount on Form IT-540B, Line 27. 6 Description Code Inventory Tax 50F Ad Valorem Natural Gas 51F WEB 61773 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. SCHEDULE J-NR – 2016 NONREFUNDABLE PRIORITY 3 CREDITS Nonrefundable Child Care Credits 1 FEDERAL CHILD CARE CREDIT – Enter the amount from your Federal Form 1040A, Line 31, or Federal Form 1040, Line 49. This amount will be used to compute your 2016 Louisiana Nonrefundable Child Care Credit. 1 2 2016 LOUISIANA NONREFUNDABLE CHILD CARE CREDIT – Your Federal Adjusted Gross Income must be GREATER THAN $25,000 in order to claim a credit on this line. See Nonrefundable Child Care Credit Worksheet. 2 3 AMOUNT OF LOUISIANA NONREFUNDABLE CHILD CARE CREDIT CARRIED FORWARD FROM 2012 THROUGH 2015 – See Nonrefundable Child Care Credit Worksheet. 3 2016 LOUISIANA NONREFUNDABLE SCHOOL READINESS CREDIT – Your Federal Adjusted Gross Income must be GREATER THAN $25,000 in order to claim a credit on this line. See Nonrefundable School Readiness Credit Worksheet. 4 4 5 5 4 3 2 AMOUNT OF LOUISIANA NONREFUNDABLE SCHOOL READINESS CREDIT CARRIED FORWARD FROM 2012 THROUGH 2015 – See Nonrefundable School Readiness Credit Worksheet. 5 Additional Nonrefundable Priority 3 Credits Enter credit description and associated code, along with the dollar amount of credit claimed. See instructions beginning on page 9. Credit Description Credit Code 6 Amount of Credit Claimed 6 7 7 8 8 9 9 10 10 11 11 Description Code Description Code Atchafalaya Trace Organ Donation 200 202 Ad Valorem Natural Gas Credit Carried Forward 219 Household Expense for Physically and Mentally Incapable Persons 204 New Jobs Credit Previously Unemployed 208 Recycling Credit Description Description Code Code Research and Development 231 Biomed/University Research 300 Cane River Heritage 232 224 Tax Equalization 305 LA Community Economic Dev. 234 226 236 310 Refunds by Utilities Apprenticeship Manufacturing Establishments Eligible Re-entrants 228 238 315 210 Ports of Louisiana Investor Enterprise Zone 399 Basic Skills Training 212 Neighborhood Assistance 230 Ports of Louisiana Import Export Cargo Other 240 Inventory Tax Credit Carried Forward and ITEP 218 CONTINUE ON NEXT PAGE. WEB 61774 ATTACH TO RETURN IF COMPLETED. Enter your Social Security Number. SCHEDULE J-NR – 2016 NONREFUNDABLE PRIORITY 3 CREDITS ...CONTINUED Transferable, Nonrefundable Priority 3 Credits Enter credit description, associated code, along with the dollar amount of credit claimed and the State Certification Number from Form R-6135. See instructions beginning on page 9. Credit Description Credit Code Amount of Credit Claimed 12 12 12A 13 13 13A 14 14 14A 15 15 15A 16 TOTAL NONREFUNDABLE PRIORITY 3 CREDITS – Add Lines 2 through 15. Also, enter this amount on Form IT-540B, Line 22. Description Code Description Code 16 Description Description Code Code Motion Picture Investment 251 Digital Interactive Media 254 LCDFI 258 Motion Picture Infrastructure 261 Research and Development 252 Motion Picture Resident 256 New Markets 259 Angel Investor 262 Historic Structures 253 Capital Company 257 Brownfields Investor 260 Other 299 WEB 61775 ATTACH TO RETURN IF COMPLETED. 2016 Louisiana Refundable Child Care Credit Worksheet (For use with Form IT-540B) Your Name Social Security Number Your Federal Adjusted Gross Income must be $25,000 or less and your child care expenses must have been incurred in Louisiana in order to complete this form. See instructions on page 12. 1. Care Provider Information Schedule – Complete columns A through D for each person or organization that provided the care to your child. You may use Federal Form W-10, supplied by your provider, to obtain the information. If your care provider does not provide a Federal Form W-10, complete those parts of the Care Provider Information Schedule for which you have the information. You must follow the same rules of “Due Diligence” as the IRS requires if you do not have all of the care provider information. See the IRS 2016 Publication 503 for information on “Due Diligence.” If additional lines are required for Lines 1 or 2, attach a schedule. Falsification of any information provided on this form constitutes fraud and can result in criminal penalties. The Child Care Credit may only be taken for child care expenses incurred in Louisiana during the time a person was a Louisiana resident. A B C D Care provider’s name Address (number, street, apartment number, city, state, and ZIP) Identifying number (SSN or EIN) Amount paid (See instructions.) .00 .00 .00 .00 .00 2. For each child under age 13, enter their name in column E, their Social Security Number in column F, and the amount of Qualified Expenses you incurred and paid in 2016 in column G. See the definitions on page 12 for information on Qualified Expenses. E F G Qualifying person’s name Qualifying person’s Social Security Number Qualified expenses you incurred and paid in 2016 for the person listed in column E First Last .00 .00 .00 .00 .00 3 Add the amounts in column G, Line 2. Do not enter more than $3,000 for one qualifying person or $6,000 for two or more persons. Enter this amount here and on Form IT-540B, Line 15A. 3 4 Enter your earned income. See the definitions on page 12. 4 5 If married filing jointly, enter your spouse’s earned income (If your spouse was a student or was disabled, see IRS Publication 503.) All other filing statuses, enter the amount from Line 4. 5 6 Enter the smallest of Lines 3, 4, or 5. Also enter this amount on Form IT-540B, Line 15B. 6 .00 7 Enter your Federal Adjusted Gross Income from Form IT-540B, Line 7. 7 .00 .00 .00 .00 Enter on Line 8 the decimal amount shown below that applies to the amount on Line 7. 8 9 If Line 7 is: over but not over $0 $15,000 $17,000 $19,000 $21,000 $23,000 $15,000 .35 $17,000 .34 $19,000 .33 $21,000 .32 $23,000 .31 $25,000 .30 Multiply Line 6 by the decimal amount on Line 8 and enter the result here. decimal amount 8 X . _______ 9 10 Multiply Line 9 by 50 percent and enter this amount on Line 11 below. 10 11 Enter this amount on Form IT-540B, Line 15. 11 .00 X .50 .00 WEB 61763 ATTACH THIS WORKSHEET TO YOUR RETURN. 2016 Louisiana Refundable School Readiness Credit Worksheet (For use with Form IT-540B) Your Name Social Security Number R.S. 47:6104 provides a School Readiness Credit in addition to the credit for child care expenses as provided under R.S. 47:297.4. To qualify for this credit, the taxpayer must have Federal Adjusted Gross Income $25,000 or less and must have incurred child care expenses for a qualified depen­dent under age six who attended a child care facility that is participating in the Quality Start Rating program administered by the Louisiana Department of Education. The qualifying child care facility must have provided the taxpayer with Form R-10614 which verifies the facility’s name, the state license number, the LA Revenue Account number, the Quality Star Rating, and the rating award date. Complete this worksheet only if you claimed a Louisiana Refundable Child Care Credit on Form IT 540B, Line 15. 1. Enter the amount of 2016 Louisiana Refundable Child Care Credit found on the Louisiana Refundable Child Care Credit Worksheet, page 15, Line 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . 00 Using the Quality Star Rating of the child care facility that your qualified dependent attended during 2016, shown on Form R-10614, determine the applicable percentage for the School Readiness Credit from the chart shown below: A Quality Rating B Percentages for Star Rating Five Star 200% (2.0) Four Star 150% (1.5) Three Star 100% (1.0) Two Star 50% (.50) One Star 0% (.00) 2. Enter the number of your qualified dependents under age six who attended a: Five Star Facility ________ and multiply the number by 2.0. . . . . . . . . . . . . . . . . (i) __________ . ______ Four Star Facility ________ and multiply the number by 1.5. . . . . . . . . . . . . . . . . (ii) __________ . ______ Three Star Facility ________ and multiply the number by 1.0. . . . . . . . . . . . . . . . . (iii) __________ . ______ Two Star Facility ________ and multiply the number by .50 . . . . . . . . . . . . . . . . (iv) __________ . ______ 3. Add lines (i) through (iv) and enter the result here. Be sure to include the decimal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 __________ . ______ 4. Multiply Line 1 by the total on Line 3. If the number results in a decimal, round to the nearest dollar and enter the result here and on Form IT-540B, Line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ______________ . 00 On Form IT-540B, Line 16 enter in the boxes designated for 5, 4, 3, or 2 the number of your qualified dependents as shown on Line 2 above for the associated Star rated facility. WEB 61764
Extracted from PDF file 2016-louisiana-form-it-540b.pdf, last modified October 2013

More about the Louisiana Form IT-540B Individual Income Tax Nonresident TY 2016

This packet includes the nonresident income tax return for Louisiana as well as all associated schedules and forms.

We last updated the Nonresident Income Tax Return in February 2017, so this is the latest version of Form IT-540B, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form IT-540B directly from TaxFormFinder. You can print other Louisiana tax forms here.


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Other Louisiana Individual Income Tax Forms:

TaxFormFinder has an additional 34 Louisiana income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form IT-540 Resident Income Tax Return
Form IT-540B Nonresident Income Tax Return
Form R-540INS Refund Request of LA Citizens for Property Insurance-Individual
Form R-210R Resident Underpayment Penalty Computation Worksheet
Form R-210NR Nonresident and Part-Year Resident Underpayment Penalty Computation Worksheet

Download all LA tax forms View all 35 Louisiana Income Tax Forms


Form Sources:

Louisiana usually releases forms for the current tax year between January and April. We last updated Louisiana Form IT-540B from the Department of Revenue in February 2017.

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Form IT-540B is a Louisiana Individual Income Tax form. Many states have separate versions of their tax returns for nonresidents or part-year residents - that is, people who earn taxable income in that state live in a different state, or who live in the state for only a portion of the year. These nonresident returns allow taxpayers to specify which which income is subject to the state's taxes, and which is not.

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 Louisiana Form IT-540B

We have a total of six past-year versions of Form IT-540B 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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While we do our best to keep our list of Louisiana Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.

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Source: http://www.taxformfinder.org/louisiana/form-it-540b