Form 515 - Maryland Tax Return - 2003
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1
2FORM
FOR NONRESIDENTS EMPLOYED IN MARYLAND WHO
2003
515
RESIDE IN JURISDICTIONS OF DELAWARE, NEW YORK
AND PENNSYLVANIA THAT IMPOSE A LOCAL INCOME
$
OR EARNINGS TAX ON MARYLAND RESIDENTS
NONRESIDENT
MARYLAND TAX RETURN
LOCAL TAX
(OR FISCAL YEAR BEGINNING
2003, ENDING
)
SOCIAL SECURITY #
SPOUSE’S SOCIAL SECURITY #
Last Name
Your First Name
Initial
Spouse’s First Name
Last Name
Initial
PRESENT ADDRESS (No. and street)
Zip Code
City or Town
State
Maryland
City, town or taxing area
Name of county and incorporated city, town
County
or special taxing area in which you were
employed on the last day of the tax period
(See Instructions)
EXEMPTIONS
YOUR FILING STATUS
— See Instruction 2 to determine if you are required to file.
—
See Instructions
Exemption Amount
Enter No.
(A) Yourself
Spouse
(A)
$2,400 $ _________
1.
Single
(If you can be claimed on another person’s tax return, use Filing Status 6)
Checked
Check here if you are:
Spouse is:
2.
Married filing joint return or spouse had no income
Enter No.
(B)
(B)
$1,000 $ _________
Checked
3.
Married filing separately
(
)
65 or over
65 or over
Blind
Blind
Spouse’s social security no.
4.
Head of household
(C)
$2,400 $ _________
Enter Total
(C) Dependent Children:
5.
Qualifying widow(er) with dependent child
Name(s)
Social Security number(s)
________________________________ __ __ __-__ __-__ __ __ __
6.
Dependent taxpayer
(Enter 0 in Exemption Box (A)—See Instruction 7)
________________________________ __ __ __-__ __-__ __ __ __
RESIDENCE INFORMATION
________________________________ __ __ __-__ __-__ __ __ __
Enter your state of legal residence.
_______________________________________
65
(D) Other Dependents:
Regular
(D)
$2,400 $ _________
If not a resident for a full year, give dates.
or over
Enter Total
Name(s) and Relationship(s)
Social Security number(s)
FROM
TO
_____________________
_____________________
________________________________ __ __ __-__ __-__ __ __ __
In what local taxing jurisdiction did you reside on the last day of the tax period?
________________________________ __ __ __-__ __-__ __ __ __
Total
Did you file a Maryland income tax return for 2002? Yes
No
(E) Enter Total Exemptions (Add A, B, C and D)
(E)
$ _________
Amount
If “Yes,” was it a
Resident or a
Nonresident Return?
FEDERAL
MARYLAND
NON-MARYLAND
INCOME (LOSS)
INCOME AND ADJUSTMENTS INFORMATION (See Instructions)
INCOME (LOSS)
INCOME (LOSS)
1. Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2. Taxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Place
your
3. Dividend income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
check
4. Taxable refunds, credits or offsets of state and local income taxes . . . . .
4
or
5. Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
money
order
6. Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
on top
7. Capital gain or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
of your
wage
8. Other gains or (losses) (from federal Form 4797) . . . . . . . . . . . . . . . . . .
8
and tax
9. Taxable amount of pensions, IRA distributions, and annuities . . . . . . . .
9
state-
10. Rents, royalties, partnerships, estates, trusts, etc. (Circle appropriate item) .
10
ments
and
11. Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
attach
12. Unemployment compensation (insurance) . . . . . . . . . . . . . . . . . . . . . . . .
12
here
with
13. Taxable amount of social security and tier 1 railroad retirement benefits .
13
ONE
14. Other income (including lottery or other gambling winnings) . . . . . . . . .
14
staple.
15. Total income (Add lines 1 through 14) . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
16. Total adjustments to income from federal return (IRA, alimony, etc.) . .
16
17. Adjusted gross income (Subtract line 16 from line 15) . . . . . . . . . . . . . .
17
ADDITIONS TO INCOME (See Instructions)
Dollars
18
18.
Non-Maryland loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
19.
Other (Enter code letter(s) from Instruction 11)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
20.
Total Additions (Add lines 18 and 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
21.
Total federal adjusted gross income & Maryland additions (Add lines 17 (Column 1) and 20) . . . . . . . . . . . . .
SUBTRACTIONS FROM INCOME (See Instructions)
22
22.
Non-Maryland income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
23.
Other (Enter code letter(s) from Instruction 12)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
24.
Total Subtractions (Add lines 22 and 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25
25.
Maryland adjusted gross income (Subtract line 24 from line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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