Form 502el - Maryland Personal Income Tax Declaration For Electronic Filing - 1999
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1Taxpayer's first name and middle initial
Last name
Social Security number
Spouse’s first name and middle initial
Last name
Social Security number
Attach
Label
Present address (number and street)
City or town
State
ZIP code
Name of county and incorporated city, town or special
Maryland county
City, town or taxing area
taxing area in which you were a resident on the last
day of the taxable period.
1. Federal adjusted gross income .................................................................................................................................
22. Maryland taxable net income ....................................................................................................................................
39. Total Maryland income tax, local income tax and contributions .............................................................................
44. Total payments and credits .......................................................................................................................................
47. Amount of overpayment to be credited to 2000 estimated tax ..............................................................................
48. Amount of overpayment to be refunded ................................................................................................
REFUND
50. Total amount due (Pay in full by April 17, 2000 with Form 502PV. See instructions)..........................................
51a.
Type of account
Checking
Savings
51b. Routing number
Attach
51c.
Account number
Wage
I consent that my refund be directly deposited as designated above, and declare that the information shown on lines 51a through
and
51c is correct. If I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund.
Tax
By consenting, I also agree to disclose to the Maryland State Treasurer’s Office certain income tax information including name,
Statements
amount of refund and the above bank information. This disclosure is necessary to effect direct deposit.
Here
NOTE: If you check this box, your refund will be directly deposited to the bank account numbers shown above. Please be sure
these numbers are correct.
Taxpayer's signature
Date
Spouse’s signature (if joint return, both must sign)
Date
Please sign here
I do not want direct deposit of my refund or am not receiving a refund.
Under penalties of perjury, I declare that I have compared the information contained on my electronic return with the information that I provided to my
electronic return originator and that the name(s), address and amounts described above agree with the amounts shown on the corresponding lines of my 1999
Maryland electronic income tax return. To the best of my knowledge and belief, my return is true, correct and complete. I consent that my return, including
accompanying schedules and statements, be sent to the Maryland Revenue Administration Division by my electronic return originator through the state-selected
third party network. This declaration is to be retained at the site of the electronic return originator.
Please
Sign
Taxpayer's signature
Date
Spouse’s signature (if joint return, both must sign)
Date
Here
Please wait ten (10) days after the electronic return preparer receives a valid acknowledgement before
calling 410-260-7701 from Central Maryland, or 1-800-218-8160 from elsewhere, about your refund.
I declare that I have reviewed the taxpayer’s return and that the entries on this form are complete and correct to the best of my knowledge. I have
obtained the taxpayer’s signature before submitting the return to the Maryland Revenue Administration Division, have provided the taxpayer with a
copy of all forms and information to be filed with the Maryland Revenue Administration Division, and have followed all other requirements described
in Publication EFL 2, Handbook for Electronic Filers of Maryland Personal Income Tax Returns (Tax Year 1999).
Date
Your Social Secuity number
Originator’s
Electronic
/
/
signature
Return
Originator
Firm’s name (or yours
EFIN
if self-employed)
Use Only
and address
ZIP code
Phone
COT/RAD-059
Rev. 9/99
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