FORM STATE OF HAWAII — DEPARTMENT OF TAXATION DO NOT WRITE IN THIS AREA

N-15(Rev. 2023) Individual Income Tax Return
 NONRESIDENT and PART-YEAR RESIDENT
  Calendar Year 2023
  M M    D      ORD      Y Y                      M M     D D     Y Y
N15_I 2023A 01 VID01 Tax Year thru
Part-Year Resident Nonresident Nonresident Alien or Dual-Status Alien MSRRA Composite
 (Enter period of Hawaii residency above)               
AMENDED Return 
FOR OFFICE USE ONLY
NOL Carryback 

IRS Adjustment                     THIS 
First Time Filer
Please Write Using a Black Ink Pen. 
Enter One Letter Or Number In Each Box. SPACE  
Fill In Ovals Completely.  Do NOT Submit a Photocopy!!

ATTACH A COPY OF YOUR 2023 FEDERAL RESERVED
INCOME TAX RETURN
Your First Name M.I. Your Last Name Suffix
u IMPORTANT — Complete this Section u
 
Spouse’s First Name M.I. Spouse’s Last Name Suffix Enter the first four letters  
of your last name. 
Use ALL CAPITAL letters 
Your Social 
Care Of (See Instructions, page 8.) Security Number

Deceased  Date of Death
Present mailing or home address (Number and street, including Rural Route)   M M        D D       Y Y  
Enter the first four letters  
of your Spouse’s last name.  
Use ALL CAPITAL letters
City, town or post office State Postal/ZIP code Spouse's Social 
Security Number
• ATTACH COPY 2 OF FORM W-2 HERE •
 
 If Foreign address, enter Province and/or State  Country Deceased  Date of Death
 
  M M        D D       Y Y  
 
  (Fill in only ONE oval)
  1   Single    4  Head of household (with qualifying person).  If the qualifying 
 
 2    Married filing joint return (even if only one had income). person is a child but not your dependent, enter the child’s full 
 3    Married filing separate return.  Enter spouse’s SSN and name. 
†
the first four letters of last name above. Enter spouse’s full  __________________________________
name here.  _____________________________________    5  Qualifying surviving spouse (see page 9 of the Instructions)

CAUTION: If you can be claimed as a dependent on another person’s tax return (such as your parents’), DO NOT fill in oval 6a, but be sure to fill in the oval below line 37.
 6a Yourself ........................................   Age 65 or over ............................................................... Enter the number of ovals 
filled on 6a and 6b ............ Â
 6b Spouse ........................................   Age 65 or over ...............................................................}
 If you filled ovals 3 and 6b above, see the Instructions on page 10 and if your spouse meets the qualifications, fill in this oval
 6c Dependents: If more than 6 dependents   2. Dependent’s social
1. First and last name use attachment  security number 3. Relationship
 and Enter number of 
 6d your children listed  ...... 6c Â
Enter number of 
other dependents ........6d Â
• ATTACH CHECK OR MONEY ORDER HERE • 
  
 6e Total number of exemptions claimed.  Add numbers entered in boxes 6a thru 6d above .............................................. 6e Â

N151E3T4 ID NO 01 FORM N-15 (REV. 2023)

Form N-15 (Rev. 2023)                                                                                                                    Page 2 of 4
                                                        Your Social Security Number                  Your Spouse’s SSN

                                                  Name(s) as shown on return
N15_I 2023A 02 VID01                                                                  ___________________________________________________
                                                           If amount is negative (loss), shade the minus (-) in the box.   Example:
                                                                                                                                   -
                                                                                     Col. A - Total Income          Col. B - Hawaii Income

 7   Wages, salaries, tips, etc. (attach Form(s) W-2) .........                                                7
 8   Interest income from the worksheet on page 38 of                                                      .00                            .00
     the Instructions ............................................................                             8
                                                                                                           .00                            .00
 9   Ordinary dividends ......................................................                                 9
 10  State income tax refund from the worksheet on                                                         .00                            .00
     page 38 of the Instructions ..........................................                                    10
                                                                                                           .00                            .00
 11  Alimony received .........................................................                                11
                                                                                                           .00                            .00

 12  Business or farm income or (loss) ...............................             -                       .00 12 -                       .00
 13  Capital gain or (loss) from the worksheet on 

     page 38 of the Instructions ..........................................        -                       .00 13 -                       .00
 14  Supplemental gains or (losses) 

     (attach Schedule D-1) .................................................       -                       .00 14 -                       .00
 
 15  IRA distributions ..........................................................                              15
 16  Pensions and annuities (see Instructions and                                                          .00                            .00
     attach Schedule J, Form N-11/N-15/N-40) ..................                                                16
                                                                                                           .00                            .00

 17  Rents, royalties, partnerships, estates, trusts, etc. ......                  -                       .00 17 -                       .00
 
 18  Unemployment compensation (insurance) ..................                                                  18
 19  Other income (state nature and source)                                                                .00                            .00

     ________________________________ ....................                         -                       .00 19 -                       .00
 
 20  Add lines 7 through 19 ..................... Total Income       ††            -                       .00 20 -                       .00
 21  Certain business expenses of reservists, performing  
     artists, and fee-basis government officials ..................                                            21
                                                                                                           .00                            .00
 22  IRA deduction ..............................................................                              22
 23  Student loan interest deduction from the worksheet                                                    .00                            .00
     on page 42 of the Instructions .....................................                                      23
                                                                                                           .00                            .00
 24  Health savings account deduction ...............................                                          24
                                                                                                           .00                            .00
 25  Moving expenses (attach Form N-139) .......................                                               25
                                                                                                           .00                            .00
 26  Deductible part of self-employment tax .......................                                            26
                                                                                                           .00                            .00
 27  Self-employed health insurance deduction .................                                                27
                                                                                                           .00                            .00
 28  Self-employed SEP, SIMPLE, and qualified plans ......                                                     28
                                                                                                           .00                            .00
 29  Penalty on early withdrawal of savings .......................                                            29
 30  Alimony paid (Enter name and SS No. of recipient)                                                     .00                            .00
     ________________________________ ....................                                                     30
                                                                                                           .00                            .00
         31    Payments to an individual housing account .                                                     31
         32    First $7,683 of military reserve or Hawaii                                                  .00                            .00
               national guard duty pay ................................                                        32
                                                                                                           .00                            .00
N152E3T4                                                                     ID NO 01                               FORM N-15 (REV. 2023)

Form N-15 (Rev. 2023)                                                                                                                                      Page 3 of 4
                                                            Your Social Security Number                  Your Spouse’s SSN

                                                   Name(s) as shown on return
N15_I 2023A 03 VID01                                                                               ___________________________________________________
 33    Exceptional trees deduction (attach affidavit) 
       (see page 21 of the Instructions) .................................                                                               33 
                                                                                                                            .00                                              .00
 34    Add lines 21 through 33 ......... Total Adjustments   †                                                                           34 
                                                                                                                            .00                                              .00
 35    Line 20 minus line 34 ....Adjusted Gross Income  †                     -                                                          35  -
                                                                                                                            .00                                              .00
 36   Federal adjusted gross income (see page 21 of the Instructions)                              ........36         -
                                                                                                                                                .00
  37  Ratio of Hawaii AGI to Total AGI. Divide line 35, Column B, by line 35, Column A (Compute to 3 decimal places and round to 2 decimal places) ...37  
      CAUTION:  If you can be claimed as a dependent on another person’s return, see the Instructions on page 21, and fill in this oval.                  .   
 38   If you do not itemize deductions, enter zero on line 39 and go to line 40a. Otherwise go to page 22 of the Instructions and enter your Hawaii itemized deductions here.
      38a  Medical and dental expenses
           (from Worksheet NR-1 or PY-1) ..............................38a                       
                                                                                                                             .00
      38b  Taxes (from Worksheet NR-2 or PY-2)................... 38b                                                                           TOTAL ITEMIZED 
                                                                                                                             .00
                                                                                                                                                DEDUCTIONS
      38c  Interest expense (from Worksheet NR-3 or PY-3) ...........38c                                                                      39  If your Hawaii adjusted gross 
                                                                                                                             .00                income is above a certain 
                                                                                                                                                amount, you may not be  
      38d  Contributions (from Worksheet NR-4 or PY-4) ....... 38d                                                                              able to deduct all of your 
                                                                                                                             .00                itemized deductions. See the 
      38e  Casualty and theft losses                                                                                                            Instructions on page 27. Enter 
           (from Worksheet NR-5 or PY-5) ..............................38e                                                                      total here and go to line 41.
      38f  Miscellaneous deductions                                                                                          .00
           (from Worksheet NR-6 or PY-6) .............................. 38f                      
                                                                                                                             .00                                             .00
 40a   If you checked filing status box: 1 or 3 enter $2,200;  
       2 or 5 enter $4,400; 4 enter $3,212 ..................................40a                                             .00
  40b  Multiply line 40a by the ratio on line 37 ................................. Prorated Standard Deduction  †                        40b 
                                                                                                                                                                             .00
 41    Line 35, Column B minus line 39 or 40b, whichever applies. (This line MUST be filled in) ...........                             41   -
  42a Multiply $1,144 by the total number of exemptions claimed on line 6e. If you and/or your spouse are blind, deaf,                                                       .00
       or disabled, fill in the applicable oval(s), and see the Instructions. 
          Yourself               Spouse .....................................................42a 
                                                                                                                             .00
  42b  Multiply line 42a by the ratio on line 37 .............................................Prorated Exemption(s)   †                  42b 
                                                                                                                                                                             .00
  43  Taxable Income.       Line 41 minus line 42b (but not less than zero)                        ................Taxable Income    † 43   
 44   Tax. Fill in oval if from:             Tax Table;      Tax Rate Schedule;  or                                  Capital Gains Tax  Worksheet on page 41 of the Instructions.  .00
       (      Fill in oval if tax from Forms N-2, N-103, N-152, N-168, N-312, N-338, N-344, N-348, N-405,                   
        ...........................................................................................Tax    †44                                                                                                                N-586, N-615, or N-814 is included.)
 44a   If tax is from the Capital Gains Tax Worksheet, enter                                                                                                                 .00
       the net capital gain from line 8 of that worksheet .............................................             44a
  45  Refundable Food/Excise Tax Credit                                                                                                         .00
       (attach Form N-311) DHS, etc. exemptions                                .....45           
 46    Credit for Low-Income Household                                                                                       .00
       Renters (attach Schedule X) ..............................................46              
  47  Credit for Child and Dependent Care                                                                                    .00
       Expenses (attach Schedule X) ...........................................47                
  48  Credit for Child Passenger Restraint                                                                                   .00
       System(s) (attach a copy of the invoice) ............................48                   
          49    Total refundable tax credits from                                                                            .00
                Schedule CR (attach Schedule CR) ....................49                          
          50Add      lines 45 through 49        ................................................. Total Refundable Credits       †.0050     
                                                                                                                                                                             .00
          51  Line 44 minus line 50. If line 51 is zeroAdjusted Tax Liability                                                † 51            -                                        or less, see Instructions. ............
                                                                                                                                                                             .00
N153E3T4                                                                     ID NO 01                                                           FORM N-15 (REV. 2023)

Form N-15 (Rev. 2023)                                                                                                                                                                                         Page 4 of 4
                                                                                 Your Social Security Number                  Your Spouse’s SSN

                                                                       Name(s) as shown on return
N15_I 2023A 04 VID01                                                                                                     ___________________________________________________

  52  Total nonrefundable tax credits (attach Schedule CR) ..................................................................                               52
                                                                                                                                                                                                              .00
  53            Line 51 minus line 52 ................................................................................................ Balance   †          53     -
  54            Hawaii State Income tax withheld (attach W-2s)                                                                                                                                                .00
                (see page 29 of the Instructions for other attachments) .....54                      
  55  2023 estimated tax payments on                                                                                                             .00
                Forms N-200V _____________ ;  N-288A _____________  55 
                                                                                                                                                 .00                                  TOTAL  
                                                                                                                                                                                    PAYMENTS
  56                            Amount of estimated tax applied from 2022 return .................56                                             .00                    58  Add lines 54 through 57.
  57            Amount paid with extension ...............................................57         
  59            If line 58 is larger than line 53, enter the amount OVERPAID                                                                     .00                                                          .00
                (line 58 minus line 53) (see Instructions) .......................................................................................          59 
  60                            Contributions to (see page 30 of the Instructions): ........................            Yourself   Spouse                                                                     .00
                                60a   Hawaii Schools Repairs and Maintenance Fund .....................                     $2           $2
                                60b   Hawaii Public Libraries Fund ...................................................      $5           $5
                                60c  Domestic and Sexual Violence / Child Abuse and Neglect Funds .............             $5           $5
  61  Add the amounts of the filled ovals on lines 60a through 60c and enter the total here .................                                               61
                                                                                                                                                                                                              .00
  62  Line 59 minus line 61 ....................................................................................................................            62 
  63            Amount of line 62 to be applied to                                                                                                                                                            .00
                your 2024 ESTIMATED TAX ..............................................63             
  64a           Amount to be               REFUNDED TO YOU (line 62 minus line 63) If filing late,                        see page 30 of Instructions..00       Fill in this oval       if this refund will 
                ultimately be deposited to a foreign (non-U.S.) bank.  Do not complete lines 64b, 64c, or 64d.

 64b            Routing number                                                                  64c  Type:                  Checking               Savings

 64d            Account number                                                                                                 ...........................  64a 
                                                                                                                                                                                                              .00
                                                                                                                           
  65                            AMOUNT YOU OWE (line 53 minus line 58). ...............................................................................  65 
  66                            PAYMENT AMOUNT Submit payment online at hitax.hawaii.gov or attach check or                                                                                                   .00
                money order payable to “Hawaii State Tax Collector.” ..................................................................                     66 
  67                            Estimated tax penalty. (See page 31 of Instr.) Do not include this amount                                                                                                     .00
                in line 59 or 65.  Fill in this oval if Form N-210 is attached          †         67
                                                                                                                                                 .00
  68                            AMENDED RETURN ONLY -  Amount paid (overpaid) on original return. (See Instructions) (attach Sch. AMD) .........  68               -
                                                                                                                                                                                                              .00
  69                            AMENDED RETURN ONLY -  Balance due (refund) with amended return. (See Instructions) (attach Sch. AMD) .....  69                    -
                                If designating another person to discuss this return with the Hawaii Department of Taxation, complete the following. This is not a full power of  .00
                                attorney. See page 32 of the Instructions.
              DESIGNEE          Designee’s name       † †                                                  Phone no.   ††                                   Identification number     ††
  HAWAII ELECTION                                             Indicate if you want $3 to go to the Hawaii Election Campaign Fund.                                  Yes       Note: Filling in the “Yes” oval will 
  (SeeCAMPAIGNpage 32 of theFUNDInstructions)            ÂÂ   If joint return, indicate if your spouse designates $3 to go to the fund.                            Yes       not change your tax or refund.
                                                            
                                DECLARATION — I declare, under the penalties set forth in section 231-36, HRS, that this return (including accompanying schedules or statements) has been examined by me and, to the best 
                                of my knowledge and belief, is a true, correct, and complete return, made in good faith, for the taxable year stated, pursuant to the Hawaii Income Tax Law, Chapter 235, HRS.
                                   Your signature                                          Date                                Spouse’s signature(ifDate                                                                  filing jointly, BOTH must sign) 

                                †                                                                                         †
                                   Your Occupation                                         Daytime Phone Number                Your Spouse’s Occupation                                 Daytime Phone Number
       PLEASE 
                       SIGN HERE
                                Paid       Preparer’s                                                                            Date                       Check if                PTIN 
                                Preparer’s Signature   ††                                                                                                   self-employed    † † o † †
                                Information
                                           Print                                                                                                                                 † †
                                           Preparer’s Name  ††                                                                                              Federal E.I. No.  

                                           Firm’s name (or yours    ††                                                                                      Phone No.  † † 
                                           if self-employed),       
                                           Address, and ZIP Code                                                                
N154E3T4                                                                                   ID NO 01                                                                              FORM N-15 (REV. 2023)