Form Nr - Delaware Individual Non-Resident Income Tax Return - 2003
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1
2DELAWARE INDIVIDUAL
NR
DO NOT WRITE OR STAPLE IN THIS AREA
NON-RESIDENT
2003
INCOME TAX RETURN
FORM 200-02
or Fiscal year beginning
and ending
Your Social Security No.
Spouse’s Social Security No.
DO NOT COVER SOCIAL SECURITY NUMBERS
(Attach Label Here)
Your Last Name
Your First Name and Middle Initial
Jr., Sr., III., etc
Spouse’s Last Name
Spouse’s First Name
Jr., Sr., III., etc
Present Home Address (Number and Street)
Apt. #
City, Town or Post Office
State
Zip Code
If you were a PART-YEAR resident in 2003, give the dates you
Check if FULL-YEAR
FILING STATUS (MUST CHECK ONE)
resided in Delaware.
non-resident in 2003
1.
Single, Divorced, Widow(er) 3.
Married & Filing Separate Forms
From
2003
To
2003
Form DE2210 Attached
2.
Joint
5.
Head of Household
Month
Day
Month
Day
37.
DELAWARE ADJUSTED GROSS INCOME (Enter from reverse side, Line 30B, Column 1) .......................................... . ..............
37
00
38.
(a) If you elect the STANDARD DEDUCTION check here..........................................................................
a.
$3250
$6500
Filing Statuses 1, 3 & 5 -
Filing Status 2 -
b.
38
00
(b) If you elect to ITEMIZE DEDUCTIONS check here and enter amount from reverse side Line 36..
39.
ADDITIONAL STANDARD DEDUCTIONS (Not allowed with Itemized Deductions - see instructions)
CHECK BOX(ES)
00
39
If SPOUSE was 65 or over
and/or Blind
If YOU were 65 or over
and/or Blind
40.
TOTAL DEDUCTIONS - ADD LINES 38 & 39 and enter here...............................................................................................................
40
00
41.
TAXABLE INCOME - Subtract Line 40 from Line 37, and Compute Tax on this Amount............................................... . ......................
41
00
42.
Tax Liability Computation
Tax Liability from Tax Rate
A
Proration Decimal
Table/Schedule
Line 30 A
00
(See instructions, page 10)
Amount
B
Line 30 B
00
=
.
X
00
42
00
Personal Credits (See Instructions, page 10)
43a
Enter number of exemptions claimed on Federal return _______________ X $110. = _______________
43a
00
Multiply this amount by the proration decimal on Line 42 (X
) and enter total here............................................................
43b
CHECK BOX(ES)
Spouse 60 or Over (if filing status 2)
Self 60 or Over
Enter number of boxes checked on Line 43b ________________ X $110. = _______________
43b
00
Multiply this amount by the proration decimal on Line 42 (X
) and enter total here............................................................
44.
Tax imposed by State of ____________ (Must Attach Signed Copy of Return)
44
44
00
(Part Year Residents Only. See instructions, page 11)............................................
45.
Other Non-Refundable Credits (See instructions, page 11)..........................................
45
45
00
46.
Total Non-Refundable Credits. Add Lines 43a, 43b, 44 and 45..........................................................................................................
46
00
47.
BALANCE. Subtract Line 46 from Line 42. If Line 46 is greater than Line 42, enter “0" (Zero)........................................................
47
00
48.
Delaware Tax Withheld (W-2's and/or 1099's Required)...........................................
48
00
48
49.
2003 Estimated Tax Paid & Payments with Extensions..............................................
49
00
49
50.
S Corporation Payments (Form 1100S/A-1 Required)..............................................
50
00
50
51.
TOTAL REFUNDABLE CREDITS. Add Lines 48, 49, & 50.....................................................................................................................
51
00
52
52.
If Line 47 is greater than Line 51, subtract 51 from 47 and enter here..................................................................AMOUNT YOU OWE
00
53.
If Line 51 is greater than Line 47, subtract 47 from 51 and enter here.........................................................................OVERPAYMENT
53
00
54.
CONTRIBUTIONS TO SPECIAL FUNDS
E. Breast Cancer Educ.
00
A. Non-Game Wildlife
00
F. Organ Donations
00
.
B. U.S. Olympics
00
G. Diabetes Educ.
00
C. Emergency Housing
00
H. Veteran’s Home
00
D. Children’s Trust
00
Add Lines A thru H and enter here....................................... >
54
00
55.
AMOUNT OF LINE 53 TO BE APPLIED TO 2004 ESTIMATED TAX ACCOUNT.....................................................................ENTER >
55
00
56.
PENALTIES AND INTEREST DUE. If Line 52 is greater than $400, see estimated tax instructions......................................ENTER >
56
00
57
57.
NET BALANCE DUE. Enter the amount due (Line 52 plus Lines 54 and 56) and pay in full...........................................PAY IN FULL>
00
58.
NET REFUND. Subtract Lines 54, 55 and 56 from Line 53................................................................ZERO DUE/TO BE REFUNDED>
58
00
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and believe it is true, correct and complete.
X
Your Signature
Date
Signature of Paid Preparer
Date
X
Spouse’s Signature (If filing joint)
Date
Address-Zip Code
Home Phone____________________ Business Phone______________________
Business Phone______________________________
EIN, SSN, OR PTIN
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