Form 200-01-X - Resident Amended Personal Income Tax Return - 2005
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1
2DELAWARE
DO NOT WRITE OR STAPLE IN THIS AREA
TAX YEAR:
FORM 200-01-X
RESIDENT AMENDED
DELAWARE PERSONAL INCOME TAX RETURN
FOR TAX YEARS BEGINNING 2005
or Fiscal year beginning _______________ and ending _______________
Your Social Security No.
Spouse’s Social Security No.
FILING STATUS (MUST CHECK ONE)
1.
Single, Divorced
3.
Married & Filing
5.
Head of
Widow(er)
Separate Forms
Household
Your Last Name
First Name and Middle Initial
Jr., Sr., III., etc.
2.
Joint
4.
Married & Filing Combined
Separate on this form
Spouse’s Last Name
Spouse’s First Name
Jr., Sr., III., etc.
If you were a part year resident in the tax year, give the dates you
resided in Delaware.
From
To
Present Home Address (Number and Street)
Apt. #
Month
Day
Year
Month
Day
Year
City
State
Zip Code
Filing Status 4 ONLY
All other filing statuses
Form DE2210
Spouse Information
You or You plus Spouse
Attached
COLUMN A
COLUMN B
COMPLETE ALL SECTIONS OF THIS RETURN. NAMES AND SSN’S MUST MATCH ORIGINAL
CORRECTED AMOUNTS
1.
DELAWARE ADJUSTED GROSS INCOME...
.
..
1
00
00
.......................
.......................
........................................
2a.
If you elect the DELAWARE STANDARD DEDUCTION check here........................
$3250
$3250
Filing Statuses 1, 3 & 5 Enter
in Column B
Filing Status 4 Enter
in Column A and in Column B
$6500
Filing Status 2 Enter
in Column B
If you elect the DELAWARE ITEMIZED DEDUCTIONS check here.........................
b.
2
00
00
Filing Statuses 1, 2, 3 & 5, enter Itemized Deductions in Column B. Filing Status 4 enter in Columns A and B.
ADDITIONAL STANDARD DEDUCTIONS (Not allowed with Itemized Deductions - use worksheet on back)
3.
CHECK BOX(ES)
00
00
3
If SPOUSE was 65 or over
and/or Blind
If YOU were 65 or over
and/or Blind
4.
TOTAL DEDUCTIONS - Add Lines 2 & 3 and enter here..............................................................
4
00
00
5.
TAXABLE INCOME - Subtract Line 4 from Line 1, Compute Tax on this Amount...........................
5
00
00
6.
Tax Liability from Tax Rate Table/Schedule
00
00
6
7.
Tax on Lump Sum Distribution (Form 329)
00
00
7
8.
TOTAL TAX -
8
00
00
Add Lines 6 and 7 and enter here.......................................................................'
Enter number of exemptions claimed on Federal return
X $110. ...............................
9a.
9a
00
00
On Line 9a, enter the number of exemptions for:
Column A
Column B
CHECK BOX(ES)
.
Spouse 60 or over (Column A)
Self 60 or over (Column B)
9b
00
00
Enter number of boxes checked on Line 9b.
X $110. ...................................................
9b
10. Tax imposed by State of
(Must attach a signed copy of return).................
10
00
00
11.
11
00
00
Volunteer Firefighter Company # ____ /Other Non-Refundable Credits.........................................
12. Child Care Credit (Must attach Form 2441; Sch. 2, 1040A) (Use worksheet on back).................
12
00
00
13. Total Non-Refundable Credits. Add Lines 9a, 9b, 10, 11 & 12 and enter here...............................
13
00
00
14. BALANCE (Subtract Line 13 from Line 8.) Cannot be less than ZERO.........................................
14
00
00
15. Delaware Tax withheld (W2's/1099 Required)
00
00
15
16.
00
00
16
Estimated Tax Paid & Payments with Extensions
17.
00
00
17
)
S Corporation Payments (Form 1100S/A-1 Required
18. Amount paid (if any, see instructions)................
00
00
18
19. TOTAL Refundable Credits. Add Lines 15, 16, 17 and 18 and enter here...................................' 19
00
00
20. Refund received (if any, see instructions)........................................................................................
20
00
00
21. Estimated tax carryover and/or Special Funds contributions as shown on original return...............
21
00
00
22. Subtract Lines 20 and 21 from Line 19 ..........................................................................................
22
00
00
23.
ere..............
'
23
00
00
BALANCE DUE. If Line 14 is more than Line 22, subtract 22 from 14 and enter h
24. OVERPAYMENT. If Line 22 is more than Line 14, subtract 14 from 22 and enter here..............' 24
00
00
00
25.
AMOUNT OF LINE 24 TO BE APPLIED TO YOUR ESTIMATED TAX ACCOUNT (See Instructions) ENTER >
25
00
26. PENALTIES AND INTEREST DUE........................................................................................................ ENTER >
26
00
27. NET BALANCE DUE (Line 23 plus Lines 25 and 26).....................................................................PAY IN FULL >
27
28. NET REFUND (subtract Lines 25 and 26 from Line 24)...................................TO BE REFUNDED/ZERO DUE >
28
00
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and believe it is true, correct and complete.
X
Your Signature
Date
Signature of Paid Preparer
Date
X
Spouse’s Signature (If filing joint)
Date
Address-Zip Code
Home Phone__________________ Business Phone__________________
Business Phone__________________________
EIN, SSN, OR PTIN
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