General Sales Tax Deduction Income Worksheet
(for use with IRS Sales Tax Calculator)

Taxpayer Information:

Taxpayer's Name: Tax Year:
Number of Exemptions (line 6d): Zip Code:
Income Worksheet:
(Enter all numbers as positive numbers)
Income DescriptionSource±Amount
AGIForm 1040, Line 38+
Tax-exempt InterestForm 1040, Line 8b+
SUBTRACT Taxable IRA Distributions1Form 1040, Line 15b-
Total IRA DistributionsForm 1040, Line 15a+
   SUBTRACT any rollover amounts included in the line above.2Form 1099-R-
SUBTRACT Taxable Pensions and Annuities1Form 1040, Line 16b-
Total Pensions and AnnuitiesForm 1040, Line 16a+
   SUBTRACT any rollover amounts included in the line above.2Form 1099-R-
SUBTRACT Taxable Social Security BenefitsForm 1040, Line 20b-
Total Social Security BenefitsForm 1040, Line 20a+
Medicaid Waiver paymentsForm 1099-Misc+
Nontaxable Combat PayFrom W-2+
Workers Compensation PaymentsTaxpayer+
Disability Insurance PaymentsTaxpayer+
Veterans Benefits (VA not DFAS)Taxpayer+
Public Assistance PaymentsTaxpayer+
Cash gifts and bequestsTaxpayer+
Residential Rental (less than 15 days)Taxpayer+
Prior Year Federal Tax RefundPrior Year 1040. line 75+
Prior Year State Tax RefundPrior Year State Return+
Portion of Prior Year State Tax Refunds that is TaxablePrior Year 1040, line 10-
Supplemental Social Security BenefitsTaxpayer+
Any Other Nontaxable Income3Taxpayer+
Income for IRS Sales Tax Calculator
The entry above shown as        may be an error.
1 Entry not required (and will be ignored) if the next line (total amount) is 0.
2 Include any 1099-R with a distribution code 6 (Tax-free Section 1035 exchange) as a rollover.
3 See Publication 4012, Page D-1, Table B for additional examples of non-taxable income.
Large Item Sales Tax Worksheet:

Sales Tax on Large Item PurchasesSourceTax
Motor Vehicle (including RVs, ATVs, etc.)Taxpayer
Watercraft or AircraftTaxpayer
Building Materials for home contruction
or remodel (if identified separately)
House (if general sales tax applies)Taxpayer
Additional Sales Tax on Specified Items for IRS Sales Tax Calculator
Record result from IRS Calculator here and print for taxpayer records:
Total Sales Tax:
Local Tax Rate (%): State Tax Rate (%):
Please send corrections and suggestions to