i‘ ~X~M~~JTATIQN OF I~cLijiXiA -OF NATE L . - - I STATE INCQME TAX REFUND RCCEIVED 3541 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA l AMCWNTS FROM 1991 SCHEDUkE A LINES 4,8,12,18,17,lB, 24 h 26 40885 AMQUlqT$ FROM Iosr SCHEWLEA LINES 4,ll 8117 612 SuaTMCT UyIE 3 FROM LINE 2 40273 I AMOUfW FROM tJNE 34, FORM 1040 . a731 0 SPf87RKT LINE 6 FROM LINE 2 , 3676 . 8 l . DIVIC)E LINE 6 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA6Y LINE 4 0.0688 MULTIPLY zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAUNE 7 BY LSNE 1 137 [fgFU~os Q~‘AMOUNTS CLAiMEI3ia-iTEMizED -a D~DUCTlONf3 J . . * -- 1, REFUND OF STATE IMXJME PER LINE 9 14-m 2. AU_ OTHER SCHEDULE A REFWdD~ 0 3. ADD LINES 1 AND 2 1464 4. TOTAL ITEMIZED DEDUCXION~ 40885 5. STANDARD DEDUCTION -a- 5708 6, SUBTRACT LINE 6 FROM WNEl4 . 36185 7, ENTER THE SMALLER OF LdNE 3 OR LINE 6 1404 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 8. TAXABLE INCOME FOR f=RlQR YEAR 179007 - .-- o, ENTER THE FCXlmOWlNG AMOlMTS TO INCLUDE IN INCOMFr IF UNE 8 IS ZERO OR MORE ENTER LINE 7 & REPORT AS INCOME FROM STATE INCOME TAX REFUND FORM 1040, LINE 10 [T”=tT’“Ma