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  Paid Preparer Information
  
  I authorize the Division of Taxation to discuss my return with my PAID preparer :   No
  PAID Preparer's Name:   
  PAID Preparer's Federal Identification Number:   
  FIRM's Name:   
  FIRM's Federal Employer Identification Number:   
  

  Taxpayer Information

  NJ WebFile Confirmation Number:
  Name:
  Your SSN: XXXXX
  Filing Status:
  Residency Status: From: 1/1/2014 To: 12/31/2014
  Address:
  City:    State:     Zip Code: - 0000
   County: 0    Municipality: 0
   E-Mail:
  Your birth year:  
  Is this the first year you are claiming an exemption for age 65 or over?
  Are you blind or totally and permanently disabled?                           
  Is this the first year you are claiming an exemption for
   blind or totally and permanently disabled?  
                                           
  Did you file an application for extension of time to file (Form NJ-630)?
  During , were you a:
  Did you live at more than one New Jersey residence during the year?
  Did you share ownership of a principal residence during the year with anyone?
  Did any principal residence you owned during the year consist of multiple
   dwelling units?
   Did anyone occupy and share rent with you for
    an apartment or other rental dwelling during the year?
Enter the amount of your share of total property taxes due and paid
on your principal residence(s) in New Jersey during :
.00
$
  Are payments "in lieu of" property taxes made on the residence you rent?
 Enter the amount of your share of total rent paid on your
principal residence(s) in New Jersey during :
.00
$
   Residency Status on :  
  Gubernatorial Elections Fund
     Do you wish to designate $1 of your taxes for this fund?

 

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  NJ WebFile Confirmation Number:

  Taxpayer Information

  Name:
  Your SSN: XXXXX
  Filing Status:
  Residency Status: From: 1/1/2014 To: 12/31/2014
  Address: 
  City:    State:     Zip Code: -0000
   E-Mail:

I am designating $1 to the Gubernatorial Elections Fund: You: No   Spouse/Civil Union Partner: No

  Exemptions

  Regular: 1  
  Age 65 or Over: 0  
  Blind or Totally and Permanently Disabled: 0  
  Number of your qualified dependent children: 0  
  Number of other dependents: 0  
  Number of dependents attending colleges: 0  

  Dependents Information

   Last Name First Name MI Social Security Number Birth Year Is Dependent Insured?

  Income Information

  Wages, salaries, tips & other employee compensation:
$ 0.00  
  Other wages not reported on Form W-2: $ 0.00  
  Taxable interest income: $ 0.00  
  Tax exempt interest income (Do not include on previous line): $ 0.00  
  Dividends and/or Capital Gains Distributions: $ 0.00  
  Net gains or income from disposition of property: $ 0.00  
  Pensions and Annuities: $ 0.00  
  IRA Withdrawals: $ 0.00  
          Pensions, Annuities and IRA subtotal: $ 0.00  
          Exclusion Amount: $ 0.00  
  Taxable Pensions, Annuities and IRA Withdrawals income: $ 0.00  
  Net Gambling Winnings: $ 0.00  
  Alimony and Separate Maintenance Payments received: $ 0.00  
  Other income: $ 0.00  
  Total Income: $ 0.00  

   Exclusion and Deduction Information

  Other Retirement Income Exclusion: $ 0.00  
  New Jersey Gross Income: $ 0.00  
  Total Exemption Amount: $ 1000.00  
  Medical Expenses: $ 0.00  
  Alimony and Separate Maintenance Payments: $ 0.00  
  Qualified Conservation Contributions: $ 0.00  
  Total Exemptions and Deductions: $ 1000.00  
  Taxable Income (After Deductions and Exemptions): $ 0.00  

  Property Tax Deduction: $ 0.00  
  New Jersey Taxable Income: $ 0.00  

  Tax Information

  Tax: $ 0.00  
  Credit for Income Taxes Paid to Other Jurisdictions: $ 0.00 
  Balance of Tax: $ 0.00 
  Use Tax Due on Internet, Mail-Order, or Other Out-of-State Purchases: $ 0.00  
  Penalty for Underpayment of Estimated Tax: $ .00  
  Total Tax: $ 0.00  

  Credits

  Total New Jersey Income Tax Withheld: $ 0.00  
  Property Tax Credit: $ 0.00  
  New Jersey Estimated Tax Payments/Credit from Tax Return: $ 0.00  
  New Jersey Earned Income Tax Credit: $ 0.00  
  EXCESS New Jersey UI/HC/WD Withheld: $ 0.00  
  EXCESS New Jersey Disability Insurance Withheld: $ 0.00  
  EXCESS New Jersey Family Leave Insurance: $ 0.00  
  Total Payments/Credits: $ 0.00  

  Balance

  Amount of overpayment you elect to credit to next year's taxes: $ 0.00  
  Contributions:    
         NJ Endangered Wildlife Fund: $10    $20    Other:   $ 0 .00 $ 0.00  
         NJ Children's Trust Fund To Prevent Child Abuse: $10    $20    Other:   $ 0 .00 $ 0.00  
         NJ Vietnam Veterans' Memorial Fund: $10    $20    Other:   $ 0 .00 $ 0.00  
         NJ Breast Cancer Research Fund: $10    $20    Other:   $ 0 .00 $ 0.00  
         U.S.S. New Jersey Educational Museum Fund: $10    $20    Other:   $ 0 .00 $ 0.00  
         Other Designated Contribution:    
  $10    $20    Other:   $ 0 .00 $ 0.00  
  Total Contributions/Credit to : $ .00  

  $ .00  

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Wages Worksheet

Primary/
Spouse/Civil Union Partner
State ID
Number
Federal
Wages
NJ State
Wages
Federal
Withholding
NJ State
Withholding
NJ
UI/HC/WD
NJ
Disability
NJ
FLI

$ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00

Totals: $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Taxable Interest Income Worksheet

Name of Payor Amount

$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00

Total: $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Tax Exempt Interest Income Worksheet

Name of Payor Amount

$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00

Total: $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Dividends Worksheet

Name of Payor Gross
Dividends
Ordinary
Dividends
Capital Gains
Distributions

$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00

Totals: $ 0.00 $ 0.00 $ 0.00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Schedule B Worksheet

Kind of Property
and Description
Date
Acquired
Date
Sold
Gross
Sales Price
 Cost or
 Other Basis
as adjusted   and expense
of sale
Gain
or (Loss)

$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00
$ .00 $ .00 $ .00

Capital Gains Distributions (From Dividends Worksheet): $ .00  
Other Net Gains: $ .00  
Net Gains: $ 0.00  

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Pensions and Annuities Worksheet - 1099 Information

Pensions and Annuities Worksheet of 0  
Worksheet for: You
Payor ID:
Gross Distribution: $ .00
Federal Withholding: $ .00
NJ State Withholding: $ .00

1. Is this a distribution from a 401(K)?:  
2. Did your employer contribute to this plan?  

3. Did you make any contributions prior to 1/1/1984?  

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Pensions and Annuities Worksheet
    Pension Distributions - 3 Year Rule

 Pensions and Annuities Worksheet 1 of 0.  
  Amount

Amount of pension you will, or have already, received during the first 3 years
(36 mos.) from the date of the first payment:
$ .00
Your contributions to the plan: $ .00
Amount of your contributions prior to that you have already recovered: $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Pensions and Annuities Worksheet
    Pension Distributions - General Rule

Pensions and Annuities Worksheet 1 of 0.  
  Amount

Amount of previously taxed contributions to the plan: $ .00
Is life expectancy a factor in your plan?  
Expected return on contract: $ .00

Amount of annual payment: $ .00
Life expectancy "multiple":  

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  IRA Withdrawals Worksheet

   Payor ID Gross
Distribution
Federal
Withholding
NJ State
Withholding
Value of
Account on
12/31/2014 Including
Contributions
Made For The
Tax Year From
1/1/2015 to
4/15/2015
Is this the
first year of distribution?
Total Amount
of Your Contributions
to This Plan
Which Were Previously
Taxed in NJ

 YOUR 1099-R(s):
1 $ .00 $ .00 $ .00 $ .00 $ .00
2 $ .00 $ .00 $ .00 $ .00 $ .00
3 $ .00 $ .00 $ .00 $ .00 $ .00

 SPOUSE/CIVIL UNION PARTNER'S 1099-R(s): (If Married/Civil Union Filing Joint Return Only)
1 $ .00 $ .00 $ .00 $ .00 $ .00
2 $ .00 $ .00 $ .00 $ .00 $ .00
3 $ .00 $ .00 $ .00 $ .00 $ .00

Totals: $ 0.00 $ 0.00 $ 0.00 $ 0.00   $ 0.00

 IRA Distributions

  Last year's
unrecovered contributions
(from line 4 of last year's
worksheet)
Amount withdrawn last year(line 2 of last year's worksheet) Taxable portion of last year's withdrawal (line 7 of last year's worksheet) Contributions to IRA
during current tax year:

 YOUR IRA Distribution Information:
1 $ .00 $ .00 $ .00 $ .00
2 $ .00 $ .00 $ .00 $ .00
3 $ .00 $ .00 $ .00 $ .00

 SPOUSE/CIVIL UNION PARTNER'S IRA Distribution Information:
1 $ .00 $ .00 $ .00 $ .00
2 $ .00 $ .00 $ .00 $ .00
3 $ .00 $ .00 $ .00 $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Schedule C Worksheet

Kind of Property Net Rental
Income (Loss)
Net Income
From Royalties
Net Income
From Patents
Net Income
From Copyrights

$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00

Totals: $ 0.00 $ 0.00 $ 0.00 $ 0.00

Net Income: $ 0.00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Gambling Winnings Worksheet

 Total Gambling Winnings: $ .00
 Total Gambling Losses: $ .00

  Did you have withholdings on the winnings?       No

 Gambling Winnings Withholdings (if applicable):

Payor ID Federal
Income
NJ State
Income
Federal
Withholding
NJ State
Withholding

$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00

Totals: $ .00 $ .00 $ .00 $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Other Income Worksheet

 Amounts Received as Prizes and Awards: $ .00
 Income in Respect of a Decedent: $ .00
 Income from Estates and Trusts: $ .00
 Scholarships and Fellowships: $ .00
 Residential Rental Value or Allowance Paid by Employer: $ .00
 Other: $ .00

  Did you have withholdings on the income?       No

 Other Income Withholdings (if applicable):

Payor ID Federal
Income
NJ State
Income
Federal
Withholding
NJ State
Withholding

$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00
$ .00 $ .00 $ .00 $ .00

Totals: $ .00 $ .00 $ .00 $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Medical Expenses Worksheet

 Total nonreimbursed medical expenses: $ 0.00
 Qualified Medical Savings Account contributions:
 from Federal Form 8853
$ .00

Medical Expenses Deduction: $ 0.00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Qualified Conservation Contribution Worksheet

 Qualified Conservation Contribution: $ .00

Total: $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Schedule A Worksheet

Income actually taxed by other jurisdiction during tax year ().   $ .00    
Income subject to tax by New Jersey $ 0.00    
Maximum Allowable Credit Percentage     %
  Column A    Column B      
Taxable Income (after Exemptions and Deductions) $ 0.00  $ 0.00    
Property Tax and Deduction
$ .00  $ .00    
New Jersey Taxable Income $ 0.00  $ 0.00    
Tax on previous line $ .00  $ .00    
Allowable Credit $    .00  $ .00    
Income or Wage tax paid to other jurisdiction         
$  .00        
Credit allowed     $ .00  $     .00   

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Payments Worksheet

 Estimated Payments made for return:

Date of Payment   Amount      Date of Payment   Amount    

$ .00  $ .00
$ .00 $ .00
$ .00 $ .00
$ .00 $ .00

    Sub Total: $ .00

 Credit from Tax Return: $ .00
 Payment made with Form NJ-630: $ .00

Total: $ .00

  NJ-1040
  State of New Jersey Income Tax - Resident Return
  For Tax Year January-December
  Earned Income Tax Credit Worksheet

 1. Did you file a Federal Schedule EIC? No
 2. Did you have the IRS figure your Federal Earned Income Credit? No

  Amount of Federal Earned Income Credit from your Federal Form 1040
  or 1040A:
$ .00

  Form TR-1040
  State of New Jersey Homestead Tenant Rebate Application

  Taxpayer Information

  Name:
  Your SSN:
  Spouse/Civil Union Partner's SSN:
  Filing Status:
  Residency Status: From: 1/1/2014 To: 12/31/2014
  Address : 
  City:    State:     Zip Code: -0000
   E-Mail:

  Income Information

  If your filing status is MARRIED/CIVIL UNION, FILING SEPARATE RETURN and you and your spouse/civil union partner maintain THE SAME PRINCIPAL RESIDENCE, gross income reported on your spouse/civil union partner's return: $ .00  
  Total Gross Income: $ 0.00  

  New Jersey Residence on //.

Address :
City:  
State:
Zip Code:  

  Tenant Information

  Enter the total rent you (and your spouse/civil union partner) paid on the rental property that was your principal residence on //: $ 0.00  
  Number of days during that you (and your spouse/civil union partner) occupied the rental property that was your principal residence on //. If you lived there for all of , enter 366.   0 
  Did anyone, other than your spouse/civil union partner, occupy and share rent with you?  
  Enter the total number of tenants (including yourself) who shared rent: (If Yes answered above)    
  Enter names and social security numbers of those sharing rent:    
  Name:     Social Security Number:   
  Name:     Social Security Number:   
  Name:     Social Security Number:   
  Enter the Total rent paid by all: $ .00 

  Schedule 1-A
  Principal residences you owned/rented in New Jersey during

  Property 1
Address:
City:
State:
Zip Code: 00000-0000
  Property 2
Address:
City:
State:
Zip Code: 00000-0000

  Homeowner
  Number of days in in this residence as an OWNER Share of property owned by YOU (and YOUR SPOUSE/CIVIL UNION PARTNER) Share of property used as your principal residence Total Property Taxes
Paid on this property
For this period
Your share of property taxes paid
on this property for this period

Property 1: 0 0 $  
$
0  
Property 2: 0 %   0 $  
$
0  

Totals:     $  
$
 

  Tenant
  Number of days in in this residence as a TENANT Total number
of tenants
who shared
the rent
TOTAL RENT paid by all people living in this residence during this period TOTAL RENT paid by YOU (and YOUR SPOUSE/CIVIL UNION PARTNER) for this residence during this period

Property 1: $  
$
0
Property 2: $  
$
0

Totals:  
$
0  
$
 
  Form NJ-1040-H
  State of New Jersey Property Tax Credit Application

  Taxpayer Information

  Name:
  Your SSN:
  Spouse/Civil Union Partner's SSN:
  Filing Status:
  Residency Status: From: 1/1/2014 To: 12/31/2014
  Address : 
  City:    State:     Zip Code: -0000
   E-Mail:

  Income Information

  New Jersey Gross Income: $ .00  



  Application Information

  Are you age 65 or older:   
  Is your spouse age 65 or older:     
  Are you blind or totally and permanently disabled:   N  
  Is your spouse blind or totally and permanently disabled:   N  
  At any time during did you own a home or rent a dwelling in New Jersey as your principal residence on which property taxes (or rent) were paid?   Y  
        If "Yes," you may be asked to provide proof of property taxes or rent paid on your principal residence at a later time.  
  On October 1, , was the principal residence that you occupied in New Jersey a home that
you owned?
  Y  
  Property Tax Credit:   $0.00  
       This is Not a Tenant Rebate Application.
Tenant rebates were suspended for .
 

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