| This table is for refunds received in TY2019 for PRIOR tax years. | |
| Taxpayer's Name | |
| Year for which the refund was issued: | |
| *Federal Filing Status | Single MFJ MFS HOH QSS |
| For Refund Tax Year | TP 65 or older TP was blind |
| For Refund Tax Year |
Dependent on another taxpayer's return
Spouse itemized SP 65 or older SP was blind |
| *Refund Amount (1099-G) | |
| *Schedule A State Taxes (Line 5) | |
| *Schedule A Itemized Deductions (Line 29) | |
| *Form 1040 Line 41 (AGI - Deductions) | |
| *Form 1040 Line 42 (Exemptions) | |
| The Taxable Oregon Refund is:     Enter into TSO Federal>>Income>>State and Local Refunds and     Enter into TSO State>>Subtractions from Income |
| Details on Calculation of Taxable Amount | |
| Amount | |
| 1. State Tax Refund (capped by Sched A Line 5)from TY2017 return | |
| 2. Total of Other Schedule A Reimbursements | |
| 3. Line 1 + Line 2 | |
| 4. Itemized Deductions | |
| 5. Amount Previously Refunded | |
| 6. Line 4 - Line 5 | |
| 7. Standard Deduction | |
| 8. Line 6 - Line 7 | |
| 9. Smaller of Line 3 and Line 8 | |
| 10. Taxable Income (1040 Line 41 - Line 42) | |
| 11. Taxable Refund Amount | |