Form PA-40 Fillable 2013 Pennsylvania Income Tax Return (PA-40)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

(: ln1) Unchecked (: ln2) Unchecked (: ln3) Unchecked (27 Enter Code Per Instructions) (a10) (a13) (a15) (a16) (a17) (a26) (a27) (a29) (a31) (a32) (a33) (a34) (a35) (a36) (Add all positive amounts from Lines 1c through Line 8) (Add amount See the instructions) (Add Lines 13 18 21 22 and 23) (Add Lines 14 15 16 17) (add) (add1) (caps) (checkbox) Unchecked (Click here if REV 1630 is included) Unchecked (Click on oval date of death) Unchecked (Click on oval if an Amended Return) Unchecked (Click on oval if an extension was filed for the return) Unchecked (Click on oval if at least two thirds of your gross income is from farming) Unchecked (Click on the appropriate oval for filing as a PA Resident Nonresident or Part Year Resident: 1) Unchecked (Click on the appropriate oval for filing as a PA Resident Nonresident or Part Year Resident: 2) Unchecked (Click on the appropriate oval for filing as a PA Resident Nonresident or Part Year Resident: 3) Unchecked (code) (dashes or spaces) (Date of Death) (Enter amount from Line 5 of PA Schedule B or total dividends if under $2 500) (Enter amount from Line 8 of PA Schedule O) (Enter amount of Line 29 to be refunded) (Enter code per instructions) (Enter date in mm/dd/yy format) (Enter Gross Compensation from Box 16 of W 2s or from Column G of Part B of PA Schedule W 2S) (Enter number of dependents per PA Schedule SP Part B Line 2) (Enter preparer s firm FEIN with dash) (Enter tax forgiveness credit from PA Schedule SP Part C Line 16) (Enter your resident credit from PA Schedules G R Column E Line 21) (Enter your total other credits from PA Schedule OC Line 15) (Fill in Oval if) Unchecked (Final Return Indicate reason:) (five) (icon) (last name) (Loss) Unchecked (Loss) Unchecked (Name of School District) (name) (Number) (our) belief they are true correct and complete (PA Tax Liability Multiply Line 11 by 3 07%) (Part Year Resident from) (Part year resident to) (s) Unchecked (s: 1) Unchecked (s: 2) Unchecked (s: 3) Unchecked (s: 4) Unchecked (See the instructions) (Spouse's Middle Initial) (Spouse's occupation) (ssn) (ssn1) (state) (Subtract Line 1b from Line 1a) (suff) (tel) (text) (Use all caps to enter spouse's first name) (Use all caps to enter spouse's last name if different from above) (Use all caps to enter taxpayer's first name) (Your Middle Initia) (Your Occupation) /2013 to /2013 10 Other Deductions Enter the appropriate code for the type of deduction 11 Adjusted PA Taxable Income Subtract Line 10 from Line 9 11 12 PA Tax Liability Multiply Line 11 by 3 07 percent (0 0307) 12 13 Total PA Tax Withheld See the instructions 13 1300110051 1300110051 1300210059 14 Credit from your 2012 PA Income Tax return 14 15 2013 Estimated Installment Payments Fill in oval if including Form REV 459B 16 2013 Extension Payment 16 17 Nonresident Tax Withheld from your PA Schedule(s) NRK 1 (Nonresidents only) 17 18 Total Estimated Payments and Credits Add Lines 14 15 16 and 17 18 19a Filing Status: 1a Gross Compensation Do not include exempt income such as combat zone pay and 1b Unreimbursed Employee Business Expenses 1c Net Compensation Subtract Line 1b from Line 1a 2 Interest Income Complete PA Schedule A if required 20 Total Eligibility Income from Part C Line 11 PA Schedule SP 21 Tax Forgiveness Credit from Part D Line 16 PA Schedule SP 21 22 Resident Credit Submit your PA Schedule(s) G R with your 23 Total Other Credits Submit your PA Schedule OC 23 24 TOTAL PAYMENTS and CREDITS Add Lines 13 18 21 22 and 23 24 25 USE TAX Add amount See the instructions 25 26 TAX DUE If the total of Line 12 and Line 25 is more than Line 24 27 Penalties and Interest See the instructions for additional 28 TOTAL PAYMENT DUE See the instructions 28 29 OVERPAYMENT If Line 24 is more than the total of Line 12 Line 25 and Line 27 3 Dividend and Capital Gains Distributions Income Complete PA Schedule B if required 30 Refund Amount of Line 29 you want as a check mailed to you REFUND 30 31 Credit Amount of Line 29 you want as a credit to your 2014 estimated account 31 32 Amount of Line 29 you want to donate to the PA Breast Cancer Coalition s Refunds 33 Amount of Line 29 you want to donate to the Wild Resource Conservation Fund 34 Amount of Line 29 you want to donate to the Military Family Relief 35 Amount of Line 29 you want to donate to the Governor Robert P Casey Memorial 36 Amount of Line 29 you want to donate to the Juvenile (Type 1) Diabetes Cure 4 5 6 7 and 8 DO NOT ADD any losses reported on Lines 4 5 or 6 4 Net Income or Loss from the Operation of a Business Profession or Farm 5 Net Gain or Loss from the Sale Exchange or Disposition of Property 6 Net Income or Loss from Rents Royalties Patents or Copyrights 7 Estate or Trust Income Complete and submit PA Schedule J 8 Gambling and Lottery Winnings Complete and submit PA Schedule T 9 Total PA Taxable Income Add only the positive income amounts from Lines 1c 2 3 Address Instructions Amended Return See the instructions Assistance Program 34 CAREFULLY PRINT YOUR SOCIAL SECURITY NUMBER(S) ABOVE City or Post Office D Deceased Date of death /2013 Daytime Telephone Number Deceased 19b PA Schedule SP DONATIONS EC OFFICIAL USE ONLY FC enter the difference here ESTIMATED TAX PAID Extension See the instructions F Final Return Indicate reason: Farmers Fill in this oval if at least Filing Status Firm FEIN First Line of Address For Breast and Cervical Cancer Research Fund from farming in PA 40 booklet information Fill in oval if including Form REV 1630/REV 1630A J Married Filing Jointly Last Name Suffix M Married Filing Separately Married N Nonresident Name of school district where you lived Name(s) OFFICIAL USE ONLY on 12/31/2013: Organ and Tissue Donation Awareness Trust Fund 35 OVERSEAS P Part Year Resident from PA 40 2013 (06 13) (FI) PA 40 2013 (06 13) (FI) 1300210051300210059 PA Department of Revenue Harrisburg PA 17129 PA Schedule(s) G S G L and/or RK 1 22 Pennsylvania Income Tax Return PLEASE DO NOT CALL ABOUT YOUR REFUND UNTIL EIGHT WEEKS AFTER YOU FILE PLEASE PRINT IN BLACK INK ENTER ONE LETTER OR NUMBER IN EACH BOX FILL IN OVALS COMPLETELY Preparer s PTIN qualifying retirement benefits See the instructions R Pennsylvania Resident Research Fund 36 Residency Status Fill in only one oval S Single School Code Second Line of Address See Foreign See the instructions See the instructions for additional information Separated Side 1 Side 2 SIGNATURE(S) Under penalties of perjury I (we) declare that I (we) have examined this return including all accompanying schedules and statements and to the best of my Social Security Number (shown first) Spouse Spouse s First Name Spouse s Last Name Only if different from Last Name above Spouse s Signature if filing jointly Preparer s Name and Telephone Number Spouse s Social Security Number (if filing jointly) Your Social Security Number State ZIP Code Suffix Tax Forgiveness Credit submit PA Schedule SP Dependents Part B Line 2 Taxpayer The total of Lines 30 through 36 must equal Line 29 two thirds of your gross income is Unmarried or Your First Name Your occupation Spouse s occupation Your Signature Date E File Opt Out