State of Rhode Island Division of Taxation 
     2023 Modification Worksheet 
     Taxable Social Security Income Worksheet                             IMAGEONLY

Name                                                                                                 Social security number

NOTE:  Use this worksheet to determine the amount, if any, of your Social Security modification on Schedule M, line 1s.

                   MODIFICATION FOR TAXABLE SOCIAL SECURITY INCOME WORKSHEET
STEP 1: Eligibility

1  Enter your date of birth................................................................................................................................... 1

2  Enter your spouse’s date of birth, if applicable...............................................................................................             2

3  Enter your Federal AGI from RI-1040 or RI-1040NR, line 1...........................................................................                         3

4  Enter your Filing Status..................................................................................................................................  4

5  Were either you or your spouse born on or before 07/01/1957?  If yes, check the box to the right.                                                           5 Yes

6  Filing status amount.  Enter the amount from below that corresponds to your filing status on line 4.............                                            6

     Single or head of household -                 $101,000

     Married filing separately -                   $101,025

     Married filing jointly or qualifying widow(er) -         $126,250

7  Is your Federal AGI on line 3 less than the filing status amount on line 6? If yes, check the box to the right..                                            7 Yes

     If you answeredbothyes to      questions 5 and 7, continue to Step 2.

     Otherwise,STOP, you are not eligible for this modification.

STEP 2: Modification Amount         DRAFT 

If you AND your spouse, if applicable, were born on or before 07/01/1957, enter 1.0000 on line 12 and skip lines 8 through 10.

8  Amount of social security benefits from Federal Form 1040 or 1040-SR, line 6a..........................................                                     8

9  Amount of line 8 attributed to the person born on or before 07/01/1957....................................................................                  9

10 Eligible percentage of social security benefits.  Divide line 9 by line 8...........................................................                        10                                  
                                                                                                                                                                 _  .  _  _  _  _

                                          09/13/2023
11 Taxable amount of social security from Federal Form 1040 or 1040-SR, line 6b...........................................                                     11

12 Eligible percentage.  Enter the percentage from line 10, or 1.0000, whichever applies.....................................                                  12
                                                                                                                                                                 _  .  _  _  _  _
13 Modification Amount. Multiply line 11 by line 12.  Enter here and on Schedule M - page 1, line 1s.                                                          13

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