Form D-408 - Nonresident Request For Refund - 2006
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D-40B Nonresident
*060401119999*
2006
Government of the
Request for Refund
District of Columbia
Important: Print in CAPITAL letters using black ink. Leave lines blank that do not apply.
Personal information
Enter your first name, middle initial and then last name
Daytime phone number
Your social security number
Current mailing address, Number, Street and Apartment
City
State
Zip Code
-
Country or U.S. commonwealth
D-40
D-40EZ
D-40B
FILL IN if you filed one of the following forms in the previous year:
If not, give reason.
Round cents to the nearest dollar.
Refund request
attach a signed copy of your state return(s)
If the amount is zero, leave the line blank.
.00
1
Total gross income
1
.00
2
DC gross income
2
.00
3
DC income tax withheld
Attach copies of your W-2 that show a DC address.
3
.00
4
2006 DC estimated income tax payments
4
0
.00
5
Refund request
Add Lines 3 and 4.
5
Residence information
(MM/DD)
(MM/DD)
6
2006 DC residence
From
To
DC address (number, street and zip code)
Zip Code + 4
7
2006 permanent residence
State
or Country or U.S. commonwealth
Yes
No
Did you return or do you intend to return to this permanent residence?
(MM/DD/YYYY)
If yes, date you returned or intend to return
Reason you lived in DC during 2006
Reason you moved or intend to move out of DC
8
List the states where you resided during the last 3 years, beginning with your present residence.
State
From (MM/YYYY)
To (MM/YYYY)
State
From (MM/YYYY)
To (MM/YYYY)
d
a
e
b
f
c
2006 D-40B P1
Nonresident Request for Refund page 1
Revised 08/06
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