Form 760 - Virginia Resident Individual Income Tax Return

FORM 760 (1999)

Page 2

VA DEPT OF TAXATION 2601031

SPOUSE

YOURSELF

USE ONLY when Filing

For use by all

Status 4 is checked

other filers

PART I - ADDITIONS TO FEDERAL ADJUSTED GROSS INCOME

28 Interest on obligations of other states, exempt from federal income tax, but not from state tax . . . . 28

29 Other additions to federal adjusted gross income as provided in instructions - Attach explanation . 29

30 TOTAL ADDITIONS (add lines 28 and 29). Enter here and on LINE 7 on front . . . . . . . . . . . . . . . . 30

PART II - SUBTRACTIONS FROM FEDERAL ADJUSTED GROSS INCOME

31 Age Deduction for Taxpayers Age 62 and Over on January 1, 2000 (See instructions.)

Each spouse computes this deduction separately.

Col. A - Spouse

Col. B - Yourself

IF YOU QUALIFY FOR THE DEDUCTIONS ON LINE 31 AND

Month - Day - Year

LINE 35, CLAIM THE ONE WHICH BENEFITS YOU THE MOST.

(a) Enter your DATE of BIRTH (For example: 03-04-30) . . . . . . . . . . . . . . . . . (a)

(b) If age 62, 63 or 64 on January 1, 2000, enter $6,000

OR if age 65 or older on January 1, 2000, enter $12,000 . . . . . . . . . . . . . (b)

YOURSELF

SPOUSE

For use by all

USE ONLY when Filing

other filers

Status 4 is checked

Filing Status 2: Add amounts on line 31(b) above and enter the total in Col. B on this line.

Filing Status 4: Enter amount(s) from line 31(b) above in Col. A and Col. B on this line . . . . . . 31

32 State income tax refund or overpayment credit reported as income on your

federal return. (Claim in the same column you reported the income on line 6.) . . . . . . . . . . . . . . . . . 32

33 Income (interest, dividends or gains) from obligations or securities of the U.S.

exempt from state income tax, but not from federal tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

34 Social Security Act and equivalent Tier 1 Railroad Retirement Act benefits

reported as taxable income on your federal return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

35 Disability income used to compute the federal income tax credit for permanently and

totally disabled persons under age 65 (see instructions - Attach federal Schedule R) . . . . . . . . . . . 35

36 Other subtractions as provided in instructions - Attach explanation . . . . . . . . . . . . . . . . . . . . . . . . 36

37 TOTAL SUBTRACTIONS (add lines 31 through 36). Enter here and on LINE 9 on front . . . . . . . . . 37

PART III - ADDITION TO TAX, PENALTY AND INTEREST (See instructions for each line.)

38 Addition to tax: Check if Form 760C

or Form 760F

was completed and enter the amount computed . . . . . . . . . . . 38

39 Penalty: See instructions. If due, check Late Filing Penalty

OR Extension Penalty

and enter amount here . . . . . . 39

40 Interest: Interest accrued on LINE 20 on front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

41 TOTAL (add lines 38, 39 and 40). Enter here and on LINE 22 on front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

COMPLETE PART IV ONLY IF AMENDING YOUR 1999 RETURN.

PART IV - COMPUTE THE AMENDED AMOUNT YOU OWE OR REFUND TO BE RECEIVED (See instructions.)

42 Amount paid with original return, plus additional tax paid after it was filed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

43 Add line 42 and line 19 on front and enter here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

44 Overpayment, if any, as shown on original return or as previously adjusted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

45 Subtract line 44 from line 43 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

46 AMOUNT YOU OWE. If line 17 on front is more than line 45, subtract line 45 from line 17. Attach payment . . . . . . . . . . . . . 46

47 REFUND to be received. If line 17 on front is less than or equal to line 45, subtract line 17 from line 45 . . . . . . . . . . . . . . . . 47

May 1, 2000

File this return on or before

, with your local Commissioner of the Revenue, Director of Finance or Director

of Tax Administration. ATTACH ALL REQUIRED VIRGINIA SCHEDULES and a COMPLETE COPY of each federal Schedule C,

C-EZ, D, E or F filed with your federal return and all other schedules supporting gross receipts and depreciation. (See instructions.)

I (We), the undersigned, declare under penalty of law that I (we) have examined this return and to the best of my (our) knowledge, it is a true, correct

and complete return. We agree that filing separately on this combined return makes us jointly and severally liable for the amount of tax shown to be due

on this return and any refunds due will be made payable to us jointly.

Your signature

Date

Your business phone number

Home phone number

(

)

(

)

Please

Sign

Spouse’s signature (if Filing Status 2 or 4, BOTH must sign)