| Taxpayer's Retirement Information Worksheet | |
| Taxpayer's Name: | |
| *Tax Year | |
| *Filing Status | MFJ Other |
| Is TP and/or SP 62 or Older? | Both TP Only SP Only Neither |
| Is TP 62 or Older? | Yes No |
| *Taxpayer's Oregon residency status? | Full Year Part Year Non Resident |
| Total Social Security benefits -Form 1040 Line 5a | |
| Taxable Social Security benefits -Form 1040 Line 5a | |
| Pension Information | |
| Total Pension Amount -Form 1040 Line 4a | |
| Taxpayer's Portion of the Above Amount (in $) | |
| Spouse's Portion is Calculated. | |
| Taxpayer Pension Amount - Portion of Form 1040 Line 4b | |
| Percent of Taxable Pension Available for Credit | 100 % |
| Retirement Income Credit Worksheet | ||
| line 1 | STOP: Taxpayer is not eligible | |
| line 2 | Enter Federal Pension Subtraction (Code 307). Use Oregon Federal Employee Calculator to determine this subtraction. | |
| line 3 | Net applicable Oregon taxable pension | |
| line 4 | Social Security ceiling | |
| line 5 | Total Social Security Benefits Form 1040 Line 5a | |
| line 6 | Unused SS available for credit (Line4 - Line5) | |
| line 7 | Household income from Household Income Worksheet | |
| line 8 | Household income base | |
| line 9 | Household income over base (Line7 - Line8) | |
| line 10 | (Line6 - Line 9) | |
| line 11 | Base for credit calculation (Smaller of Line10 and Line3) | |
| line 12 | Retirement Income Credit (code 811) Enter on Oregon Credits worksheet |
|
| Household Income Worksheet See OR 17 Appendix for a list of all items | |
| *Federal AGI from line 37, Form 1040 | |
| Additions to Household Income NOT included in AGI: | |
| Non taxable interest | |
| Non taxable dividends | |
| Scholarships not included in income | |
| Insurance payments in excess of reimbursed expenses less attorneys' fees |
|
| Inheritances | |
| Gifts and grants less $500 | |
| Non taxable military and veterans benefits | |
| Capital loss, if any, on line 13 of form 1040 in excess of $1,000 |
|
| Non Taxable Disablity Payments including SSI | |
| Non Taxable Lottery Winnings | |
| Tier 2 Railroad Retirement (Oregon Code 330) | |
| TANF-Temporary Assistance for Needy Families | |
| Other Non Taxable Items. See Appendix OR 17. Use Scratch Pad Tool to document |
|
| Subtractions from Household Income: | |
| Taxable portion of Social Security and Tier 1 Railroad Retirement income (line 20b of 1040) |
|
| Oregon state income tax refund included in AGI | |
| Household income for Retirement Income Credit | |