Form 515 - Maryland Tax Return - 2005
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1
2FORM
FOR NONRESIDENTS EMPLOYED IN MARYLAND WHO RESIDE IN JURISDICTIONS
2005
515
OF DELAWARE, NEW YORK AND PENNSYLVANIA THAT IMPOSE A LOCAL INCOME
OR EARNINGS TAX ON MARYLAND RESIDENTS
NONRESIDENT
MARYLAND TAX RETURN
$
LOCAL TAX
(OR FISCAL YEAR BEGINNING
2005, ENDING
)
SOCIAL SECURITY #
SPOUSE’S SOCIAL SECURITY #
Your First Name
Initial
Last Name
Spouse’s First Name
Initial
Last Name
PRESENT ADDRESS (No. and street)
City or Town
State
Zip Code
Name of county and incorporated city, town or special taxing
area in which you were employed on the last day of the taxable
period. (See Instruction 6)
EXEMPTIONS
—
See Instruction 9
YOUR FILING STATUS
Exemption Amount
—
See Instruction 2 to determine if you are required to file.
Enter No.
(A) Yourself
Spouse
(A)
$2,400 $____________
1.
Single
Checked
(If you can be claimed on another person’s tax return, use Filing Status 6)
Check here if you are:
Spouse is:
2.
Married filing joint return or spouse had no income
(B)
(B)
$1,000 $____________
Enter No.
Checked
65 or over
65 or over
Blind
Blind
3.
Married filing separately
SPOUSE’S SOCIAL SECURITY NUMBER
(C)
$2,400 $____________
4.
Head of household
Enter Total
(C) Dependent Children:
Name(s)
Social Security number(s)
5.
Qualifying widow(er) with dependent child
________________________________ __ __ __-__ __-__ __ __ __
6.
Dependent taxpayer
(Enter 0 in Exemption Box (A)—See Instruction 7)
________________________________ __ __ __-__ __-__ __ __ __
RESIDENCE INFORMATION
________________________________ __ __ __-__ __-__ __ __ __
Enter your state of legal residence. _______________________________________
(D) Other Dependents:
(D)
$2,400
$____________
Enter
Enter
Enter Total
No.
No.
If not a resident for a full year, give dates.
Regular
65 or over
FROM _____________________ TO _____________________
Name(s) and Relationship(s)
Social Security number(s)
________________________________ __ __ __-__ __-__ __ __ __
In what local taxing jurisdiction did you reside on the last day of the tax period?
________________________________ __ __ __-__ __-__ __ __ __
Did you file a Maryland income tax return for 2004? Yes
No
Enter Total Exemptions
(E)
Total
If “Yes,” was it a
Resident or a
Nonresident Return?
(Add A, B, C and D)
(E)
Amount
$ ___________
FEDERAL
MARYLAND
NON-MARYLAND
INCOME (LOSS)
INCOME AND ADJUSTMENTS INFORMATION (See Instruction 10)
INCOME (LOSS)
INCOME (LOSS)
1.
Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2.
Taxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
3.
Dividend income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4.
Taxable refunds, credits or offsets of state and local income taxes . . . . . .
4
5.
Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
6.
Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
7.
Capital gain or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8.
Other gains or (losses) (from federal Form 4797) . . . . . . . . . . . . . . . . . . .
8
9.
Taxable amount of pensions, IRA distributions, and annuities . . . . . . . . .
9
10.
Rents, royalties, partnerships, estates, trusts, etc. (Circle appropriate item) . .
10
11.
Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
12.
Unemployment compensation (insurance) . . . . . . . . . . . . . . . . . . . . . . . . .
12
13.
Taxable amount of social security and tier 1 railroad retirement benefits . . .
13
14.
Other income (including lottery or other gambling winnings) . . . . . . . . . .
14
15.
Total income (Add lines 1 through 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
16.
Total adjustments to income from federal return (IRA, alimony, etc.) . . . .
16
17.
Adjusted gross income (Subtract line 16 from line 15) . . . . . . . . . . . . .
17
Dollars
Cents
ADDITIONS TO INCOME (See Instruction 11)
18
18.
Non-Maryland loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
19.
Other (Enter code letter(s) from Instruction 11)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
20.
Total Additions (Add lines 18 and 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
21.
Total federal adjusted gross income & Maryland additions (Add lines 17 (Column 1) and 20) . . . . . . . . . . . .
SUBTRACTIONS FROM INCOME (See Instruction 12)
22
22.
Non-Maryland income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
23.
Other (Enter code letter(s) from Instruction 12)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
24.
Total Subtractions (Add lines 22 and 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25
25.
Maryland adjusted gross income (Subtract line 24 from line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
COM/RAD-023
05-49
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