Form 200-03 Ez - Delaware Individual Resident Income Tax Return - 2009 Page 2
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1
22009 DELAWARE RESIDENT SCHEDULES
Name(s):
Social Security Number:
COLUMNS: Column A is reserved for the spouse of those couples choosing filing status 4. (Reconcile your Federal totals to the appropriate
individual. See Page 9 worksheet.) Taxpayers using filing statuses 1, 2, 3, or 5 are to complete Column B only.
Filing Status 4 ONLY
All other filings statuses
Spouse Information
You or You plus Spouse
DE SCHEDULE I - CREDIT FOR INCOME TAXES PAID TO ANOTHER STATE
COLUMN A
COLUMN B
.
See the instructions and complete the worksheet on Page 7 prior to completing DE Schedule I
Enter the credit in HIGHEST to LOWEST amount order.
00
00
1
1. Tax imposed by State of
(enter 2 character state name)..................................
00
00
2
2. Tax imposed by State of
(enter 2 character state name)..................................
00
00
3
3. Tax imposed by State of
(enter 2 character state name)..................................
4
00
00
4. Tax imposed by State of
(enter 2 character state name)..................................
5
5. Tax imposed by State of
(enter 2 character state name)..................................
00
00
6.
Enter the total here and on EZ Return, Line 10 or Resident Return, Line 10.
You must
00
00
6
attach a copy of the other state return(s) with your Delaware tax
return.................
DE SCHEDULE II - EARNED INCOME TAX CREDIT (EITC)
Complete the Earned Income Tax Credit for each child YOU CLAIMED the Earned Income Credit for on your federal return.
CHILD 1
CHILD 2
CHILD 3
Qualifying Child Information
7. Child’s Name (First and Last Name)..................
7
8. Child’s SSN .......................................................
8
9. Child’s Year of Birth............................................
9
00
10.
Delaware State Income Tax from Line 8 (enter higher tax amount from Column A or
B)..........
10
11. Federal earned income credit from Federal Form 1040, Line 64a;
00
Form
1040A, Line 41a;
Form 1040 EZ, Line 9a........................................................................
11
.20
12. Delaware EITC Percentage (20%)............................................................................................
12
13. Multiply Line 11 by Line 12.......................................................................................................
00
13
14. Enter the Smaller of Line 10 or Line 13 above. Enter here and on EZ Return, Line 11
00
14
or Resident Return, Line 14........................................................................................................
See the instructions on Page 8 for ALL required documentation to attach.
DE SCHEDULE III - CONTRIBUTIONS TO SPECIAL FUNDS
See Page 13 for a description of each worthwhile fund listed below.
15.
00
00
A
.
00
F
.
K
.
Non-Game Wildlife
Organ Donations
Mult. Sclerosis Soc.
B
.
00
G
.
00
L
.
00
U.S. Olympics
Diabetes Educ.
Ovarian Cancer Fund
00
00
00
C
.
Emergency Housing
H
.
Veteran’s Home
M
.
21
Fund for Children
st
00
00
D
.
I
.
Children’s Trust
DE National Guard
E
.
00
J
.
00
Breast Cancer Educ.
Juv. Diabetes Fund
Enter the total Contribution amount here and on EZ Return, Line 19
00
or Resident Return, Line 23.......................................................................................................
15
This page MUST be sent in with your Delaware return if any of the schedules (above) are completed.
(Rev 11/24/09)
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