Delaware Form 200-01-X - Resident Amended Personal Income Tax Return - 1999
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1
2DELAWARE
DO NOT WRITE OR STAPLE IN THIS AREA
1999
FORM 200-01-X
RESIDENT AMENDED
DELAWARE PERSONAL INCOME TAX RETURN
YOUR LAST NAME AS SHOWN ON RETURN
YOUR FIRST NAME AND MIDDLE INITI
AL
YOUR SOCIAL SECURITY NUMBER
SPOUSE'S LAST NAME AS SHOWN ON RETURN
SPOUSE'S FIRST NAME AND MIDDLE INITI
AL
SPOUSE'S SOCIAL SECURITY NUMBER
PRESENT HOME ADDRESS (STREET, CITY, STATE, ZIP)
I
F YOU WERE A PART-YEAR RESIDENT IN 1999,
GIVE THE DATES YOU RESIDED IN DELAWARE:
FILING STATUS:
1.
3.
5.
SINGLE
MARRIED FILING SEPARATE
HEAD OF HOUSEHOLD
_______/_______/______ TO _______/_______/______
99
99
(CHECK ONE)
2.
4.
JOINT
MARRIED FILING COMBINED SEPARATE
COLUMN A
COLUMN B
...............
1.
DELAWARE ADJUSTED GROSS INCOME.................................................................................................
00
00
1.
2.
DEDUCTION - CHECK HERE
a. STANDARD............
b. ITEMIZED.................................................
00
00
2.
3.
ADDITIONAL STANDARD DEDUCTION - CHECK IF:
SPOUSE WAS 65 OR OVER
BLIND
YOU WERE 65 OR OVER
BLIND
...............
WORKSHEET ON BACK AND ENTER TOTAL HERE)................................................................................
00
00
3.
4.
TOTAL - ADD LINES 2 AND 3..............................................................................................................................................
00
00
4.
5.
NET TAXABLE INCOME - SUBTRACT LINE 4 FROM LINE 1.............................................................................................
00
00
5.
6.
TAX - FROM TAX RATE TABLE/SCHEDULE...................
00
00
6.
7.
TAX ON LUMP SUM DISTRIBUTION................................
00
00
7.
8.
TOTAL TAX - ADD LINES 6 AND 7......................................................................................................................................
00
00
8.
PERSONAL CREDITS (SEE INSTRUCTIONS)
9a. ENTER NUMBER OF EXEMPTIONS CLAIMED ON FEDERAL RETURN _______ x $100. (MULTIPLY BY $100.).........
00
00
9a.
9b. CHECK BOX(ES):
SPOUSE 60 OR OVER (COLUMN A)
SELF 60 OR OVER (COLUMN B)
ENTER NUMBER OF BOXES CHECKED ON LINE 9b _________ X $100. (MULTIPLY BY $100.)..................................
00
00
9b.
10.
TAX IMPOSED BY STATE OF _____________ ..............
00
00
10.
11.
VOLUNTEER FIREFIGHTERS/AUXILIARY AND
00
00
.....
RESCUE CREDIT......................................................
11.
12.
CHILD CARE CREDIT......................................................
00
00
12.
13.
OTHER NONREFUNDABLE CREDITS............................
00
00
13.
14. TOTAL NONREFUNDABLE CREDIT (ADD LINES 9a, 9b, 10, 11, 12, AND 13)..................................................................
00
00
14.
15.
BALANCE (SUBTRACT LINE 14 FROM LINE 8. CANNOT BE LESS THAN ZERO)..........................................................
00
00
15.
16.
DE TAX WITHHELD (W-2'S REQUIRED).........................
00
00
16.
17.
ESTIMATED TAX PAID AND PAYMENTS WITH
00
00
EXTENSIONS....................................................................
17.
18.
S CORPORATIONS PAYMENTS......................................
00
00
18.
19.
AMOUNT PAID WITH ORIGINAL RETURN
00
00
19.
20.
TOTAL REFUNDABLE CREDITS (ADD LINES 16, 17, 18, AND 19)....................................................................................
00
00
20.
21.
REFUND IF ANY AS SHOWN ON ORIGINAL RETURN.......................................................................................................
00
00
21.
22.
ESTIMATED TAX CARRYOVER AND/OR SPECIAL FUNDS CONTRIBUTION AS SHOWN ON ORIGINAL RETURN....
00
00
22.
23.
SUBTRACT LINES 21 AND 22 FROM LINE 20.....................................................................................................................
00
00
23.
24.
IF LINE 15 IS GREATER THAN LINE 23 ENTER.....................................................................................BALANCE DUE >
00
00
24.
25.
IF LINE 23 IS GREATER THAN LINE 15 ENTER...................................................................................OVERPAYMENT >
00
00
25.
26.
NET BALANCE DUE IF LINE 24 IS GREATER THAN LINE 25 ENTER..................................................................NET BALANCE DUE >
00
26.
27.
INTEREST AT 1% PER MONTH....................................................................................................................................................................
00
27.
28.
TOTAL TAX AND INTEREST DUE..................................................................................................................................................................
00
28.
29.
NET REFUND IF LINE 25 IS GREATER THAN LINE 24 ENTER............................................................................NET OVERPAYMENT >
00
29.
30.
AMOUNT TO BE CREDITED TO 2000 ESTIMATED TAX ACCOUNT...........................................................................................................
00
30.
31.
REFUND TO BE RECEIVED (SUBTRACT LINE 30 FROM LINE 29)..................................................................................NET REFUND >
00
31.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS RETURN. INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS, AND BELIEVE THAT
IT IS TRUE, CORRECT, AND COMPLETE.
YOUR SIGNATURE
DATE
SIGNATURE OF PAID PREPARER
DATE
SPOUSE'S SIGNATURE (IF FILING STATUS 2 OR 4)
DATE
EMP ID OR SOC SEC NO.
BUSINESS PHONE
HOME PHONE
BUSINESS PHONE
ADDRESS - ZIP CODE
MAKE CHECK PAYABLE AND MAIL TO: DIVISION OF REVENUE, P.O. BOX 508, WILMINGTON, DELAWARE 19899-0508
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