Form 200-02 - Delaware Individual Non-Resident Income Tax Return - 2006 Page 2

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2006 DELAWARE NON-RESIDENT FORM 200-02, PAGE 2
Delaware Source
Federal
Income/Loss
COLUMN 1
SECTION A - INCOME AND ADJUSTMENTS FROM FEDERAL RETURN
COLUMN 2
00
00
1
1.
Wages, salaries, tips, etc.................................................................................................................
00
00
2
2.
Interest...........................................................................................................................................
00
00
3
3.
Dividends........................................................................................................................................
4
00
00
4.
State refunds, credits or offsets of state & local income taxes.............................................................
00
00
5
5.
Alimony received.............................................................................................................................
00
00
6
6.
Business income or (loss) (See instructions).....................................................................................
00
00
7a
7a. Capital gain or (loss)........................................................................................................................
00
00
7b
7b. Other gains or (losses).....................................................................................................................
00
00
8
8.
IRA distributions..............................................................................................................................
9
00
00
9.
Taxable pensions and annuities........................................................................................................
00
00
10
10. Rents, royalties, partnerships, S corps, estates, trusts, etc................................................................
00
00
11
11.
Farm income or (loss)......................................................................................................................
00
00
12
12. Unemployment compensation (insurance)........................................................................................
00
00
13
13. Taxable Social Security Benefits.......................................................................................................
00
00
14
14. Other income (state nature and source)
00
00
15
15. Total income. Add Lines 1 through 14...............................................................................................
00
00
16
16. Total Federal Adjustments (See instructions).....................................................................................
00
00
17. Federal Adjusted Gross Income for Delaware purposes. Subtract Line 16 from 15..............................
17
COLUMN 1
COLUMN 2
SECTION B - DELAWARE MODIFICATIONS AND ADJUSTMENTS - ADDITIONS ( + )
00
00
18
18. Interest received on obligations of any state other than Delaware.......................................................
00
00
19
19. Fiduciary adjustment, oil depletion...................................................................................................
00
00
20
20. TOTAL - Add Lines 18 & 19.............................................................................................................
00
00
21
21.
Add Lines 17 & 20..........................................................................................................................
COLUMN 1
COLUMN 2
SECTION C - DELAWARE MODIFICATIONS AND ADJUSTMENTS - SUBTRACTIONS ( - )
00
00
22
22. Interest received on U.S. Obligations................................................................................................
00
00
23
23. Pension Exclusion/Retirement Exclusion (See instructions)...............................................................
00
00
24
24. Delaware State tax refund, Delaware Lottery......................................................................................
00
00
25
25. Fiduciary Adjustment, Work Opportunity Credit, Delaware NOL Carryforward.....................................
00
00
26
26. Taxable Social Security Benefits/Railroad Retirement Benefits/Higher Education Exclusion.................
00
00
27
27. TOTAL - Add Lines 22 through 26....................................................................................................
00
00
28. Subtract Line 27 from Line 21 and enter here....................................................................................
28
00
00
29. Exclusion for certain persons 60 and over or disabled (See instructions).............................................
29
30A.
Column 2. Subtract Line 29 from Line 28. This is your modified Delaware Source Income.
00
30A
Enter on front side Line 42, Box A
.
................................................................................................................................
30B.
Column 1. Subtract Line 29 from Line 28. This is your Delaware Adjusted Gross Income.
00
30B
Enter on front side Line 37 and Line 42, Box B.
.....................................................................
COLUMN 1
SECTION D - ITEMIZED DEDUCTIONS (ATTACH FEDERAL SCHEDULE A, FORM 1040)
31
00
31. Enter total Itemized Deductions (See instructions)...........................................................................
00
32
32. Enter Foreign Taxes Paid (See instructions).....................................................................................
33
00
33. Enter Charitable Mileage Deduction (See instructions).....................................................................
34
00
34. TOTAL - Add Lines 31, 32, and 33 .................................................................................................
00
35a
35a. Enter State Income Tax included in Line 31 above (See Instructions)................................................
35b
00
35b. Enter Form 700 Tax Credit Adjustment (See instructions)................................................................
36. Subtract Line 35a and 35b from Line 34. Enter here and on front, Line 38........................................
36
00
SECTION E - DIRECT DEPOSIT INFORMATION
If you would like your refund deposited directly
to your checking or savings account, complete boxes a, b and c below. See instructions for details.
a. Routing Number
b. Type:
Checking
Savings
DATE OF DEATH
SPOUSE
TAXPAYER
c. Account Number
/
/
/
/
Month
Day
Year
Month
Day
Year
NET BALANCE DUE (LINE 57):
NET REFUND (LINE 58):
ZERO (LINE 58):
DELAWARE DIVISION OF REVENUE
DELAWARE DIVISION OF REVENUE
DELAWARE DIVISION OF REVENUE
P.O. BOX 8752
P.O. BOX 8772
P.O. BOX 8711
WILMINGTON, DE 19899-8752
WILMINGTON, DE 19899-8772
WILMINGTON, DE 19899-8711
MAKE CHECK PAYABLE TO : DELAWARE DIVISION OF REVENUE
REMEMBER TO ATTACH APPROPRIATE SUPPORTING SCHEDULES WHEN FILING YOUR RETURN
AND KEEP A COPY OF THE RETURN FOR YOUR RECORDS
(Rev 08/15/06)

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