Form 515 - Maryland Tax Return - 2011
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1
22011
FOR NONRESIDENTS EMPLOYED IN MARYLAND WHO
FORM
515
RESIDE IN JURISDICTIONS THAT IMPOSE A LOCAL
INCOME OR EARNINGS TAX ON MARYLAND RESIDENTS
MARYLAND TAX RETURN
NONRESIDENT
$
LOCAL TAX
115150049
OR FISCAL YEAR BEGINNING
2011, ENDING
Social Security number
Spouse's Social Security number
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)
FILING STATUS
1.
Single (If you can be claimed on another person’s tax return, use Filing Status 6.)
4.
Head of household
See Instruction 2 to determine
2.
Married filing joint return or spouse had no income
5.
Qualifying widow(er) with dependent child
if you are required to file.
3.
Married filing separately
6.
Dependent taxpayer (Enter 0 in Exemption Box (A) - See Instruction 7)
CHECK ONE BOX
Spouse's Social Security number
—
See Instruction 8
RESIDENCE INFORMATION
EXEMPTIONS
(A)
Yourself
Spouse
Enter your state of legal residence.
Borough/Township (PA)
See Instruction 9
Check here
65 or over
Blind
65 or over
Blind
(B)
for
Enter 2-letter
state code
Maryland
Were you a resident for the entire year of 2011?
taxes
NOTE: If you are claiming dependents, you must attach the Dependent Form 502B to this form in order to receive the
Yes
No
If no, attach explanation.
withheld
applicable exemption amount.
in error
No
Are you or your spouse a member of the military? Yes
$ ___________
(A) Enter No. Checked . . . . .
See Instruction 9 $ __________ (B) Enter No. Checked . . . . . . .
X $1,000
Did you file a Maryland income tax return for 2010? Yes
No
If “Yes,” was it a
Resident or a
Nonresident return?
(C) Enter No. Checked from
(See instruction 2)
Advise dates you resided within Maryland for 2011.
line 1 of Dependent
(D) Enter Total Exemptions
If none, enter “NONE.”
Form 502B . . . . . . . . . . .
See Instruction 9 $ __________
Total Amount $ ___________
(Add A, B and C) . . . . .
________________
________________
FROM
TO
(1)
FEDERAL
(2)
MARYLAND
(3) NON-MARYLAND
INCOME AND ADJUSTMENTS INFORMATION (See Instruction 10)
INCOME (LOSS)
WAGE INCOME
INCOME (LOSS)
Wages, salaries, tips, etc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
1
Taxable interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
2
Dividend income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.
3
Taxable refunds, credits or offsets of state and local income taxes . . . . . . . . . .
4.
4
Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
5
Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
6
Capital gain or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
7
Other gains or (losses) (from federal Form 4797) . . . . . . . . . . . . . . . . . . . . . . .
8.
8
Place
Taxable amount of pensions, IRA distributions, and annuities. . . . . . . . . . . . . .
9.
9
CHECk
Rents, royalties, partnerships, estates, trusts, etc. (Circle appropriate item) . . . . . .
10.
10
or
Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
MONEY
11.
11
ORDER
Unemployment compensation (insurance) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12.
12
on top of
Taxable amount of social security and tier 1 railroad retirement benefits. . . . . . .
13.
your W-2
13
wage and
Other income (including lottery or other gambling winnings) . . . . . . . . . . . . . .
14.
14
tax
Total income (Add lines 1 through 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15.
15
state-
Total adjustments to income from federal return (IRA, alimony, etc.). . . . . . . .
ments and
16.
16
ATTACH
Adjusted gross income (Subtract line 16 from line 15) . . . . . . . . . . . . . . . .
17.
17
HERE
with
Dollars
Cents
ADDITIONS TO INCOME (See Instruction 11)
ONE
staple.
18
Non-Maryland loss and adjustments ...................................................................................................................................................
18.
19
Other (Enter code letter(s) from Instruction 11) ......................................................................
19.
20
Total Additions (Add lines 18 and 19) ...........................................................................................................................................
20.
21
Total federal adjusted gross income & Maryland additions (Add lines 17 (Column 1) and 20) .......................................................
21.
SUBTRACTIONS FROM INCOME (See Instruction 12)
Taxable military income of nonresident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
22.
Other (Enter code letter(s) from Instruction 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
23.
Total Subtractions (Add lines 22 and 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
24.
Maryland adjusted gross income before subtraction of non-Maryland income (Subtract line 24 from line 21). . . . . . . . . . . . . . . .
25
25.
COM/RAD-023
11-49
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