Form 765 - Unified Nonresident Individual Income Tax Return - 2004 Page 3

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2004 Virginia
Unified
*VA765L104000*
Schedule L
Nonresident Income Tax Return
(FORM 765)
List of Participants
Name of Pass-Through Entity
FEIN
Identify the Participants
Name
Address
Allocation %
SSN
i
________________________
i _______i
_____________
__________________________
1.
________________________
i
i
________________________
i _______i
_____________
__________________________
2.
________________________
i
i
________________________
i _______i
_____________
__________________________
3.
________________________
i
i
________________________
i _______i
_____________
__________________________
4.
________________________
i
i
________________________
i _______i
_____________
__________________________
5.
________________________
i
i
________________________
i _______i
_____________
__________________________
6.
________________________
i
i
________________________
i _______i
_____________
__________________________
7.
________________________
i
i
________________________
i _______i
_____________
__________________________
8.
________________________
i
i
________________________
i _______i
_____________
__________________________
9.
________________________
i
i
________________________
i _______i
_____________
_________________________
10.
________________________
i
i
________________________
i _______i
_____________
_________________________
11.
________________________
i
i
________________________
i _______i
_____________
_________________________
12.
________________________
i
i
________________________
i _______i
_____________
_________________________
13.
________________________
i
i
________________________
i _______i
_____________
_________________________
14.
________________________
i
i
________________________
i _______i
_____________
_________________________
15.
________________________
i
Va. Dept. Of Taxation 6201039 Sch L Web (Rev 10/04)

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