Form 1040NR (2009), Page 3

Summary: This is an example of Form 1040NR, page 3 with items included as described in the text. Additionally, these line items are completed:

Form 1040NR., Page 3:
- Schedule A--Itemized Deductions:
- Under State and Local Income Taxes:
- - 1. State income taxes field contains 195
  - 3. Add lines 1 and 2 field contains 195
- Under Total Itemized Deductions:
- - 17. Is Form 1040NR., line 36 over $166,800 (over $83,400 if you checked filing status box 3, 4, or 5 on page 1 of Form 1040NR)? No. Your deduction is not limited. Add the amounts in the far right column for lines 3 through 16. Also enter this amount on Form 1040NR, line 37 checkbox checked, field contains 195