Form 515 - Maryland Tax Return - 2012 Page 2

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FORM
MARYLAND NONRESIDENT
PAGE 2
515
LOCAL INCOME TAX RETURN
2012
NAME ___________________________ SSN ___________________
26. Amount from line 25 (Maryland adjusted gross income before subtraction of non-Maryland income) . . . . .
26
DEDUCTION METHOD (All taxpayers must select one method and check the appropriate box)
27. STANDARD DEDUCTION METHOD
See Instruction 14 and enter amount
27
ITEMIZED DEDUCTION METHOD
See Instruction 15 and enter amount
28. Net income (Subtract line 27 from line 26.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
29. Total exemption amount (from EXEMPTIONS area, page 1). See Instruction 16. . . . . . . . . . . . . . . . . . . . .
29
30. Enter your AGI factor (from the worksheet in Instruction 13). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
31. Maryland exemption allowance (Multiply line 29 by line 30.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
32. Taxable net income (Subtract line 31 from line 28.) Figure tax on Form 505NR . . . . . . . . . . . . . . . . . . . .
32
MARYLAND TAX COMPUTATION – Complete Form 505NR before continuing
33
33. Maryland tax from line 16 of Form 505NR. (Attach Form 505NR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34
34. Earned income credit (1⁄2 of federal earned income credit). See Instruction 19. . . . . . . . . . . . . . . . . . . .
35
35. Poverty level credit (See Instruction 19.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
36
36. Income tax credits from Part G, line 8 of Form 502CR. (Attach Form 502CR.) . . . . . . . . . . . . . . . . . . . . .
37. Business tax credits (Attach Form 500CR.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
37
38. Total credits (Add lines 34 through 37.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38
39. Maryland tax after credits (Subtract line 38 from line 33.) If less than 0, enter 0. . . . . . . . . . . . . . . . . . .
39
LOCAL TAX COMPUTATION
. 0
40
40. Local tax from line 18 of Form 505NR. Enter local tax rate used. See Instruction 20
.
41
41. Local earned income credit (from Local Earned Income Credit Worksheet in Instruction 20) . . . . . . . . . . . .
42
42. Local poverty level credit (from Local Poverty Level Credit Worksheet in Instruction 20) . . . . . . . . . . . . . .
43
43. Total credits (Add lines 41 and 42.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
44
44. Local tax after credits (Subtract line 43 from line 40.) If less than 0, enter 0 . . . . . . . . . . . . . . . . . . . . . .
45
45. Total Maryland and local tax (Add lines 39 and 44.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
46
46. Contribution to Chesapeake Bay and Endangered Species Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
47
47. Contribution to Developmental Disabilities Waiting List Equity Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . .
48
48. Contribution to Maryland Cancer Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49. Total Maryland income tax, local income tax and contributions (Add lines 45 through 48.) . . . . . .
49
50. Total Maryland and local tax withheld (Enter total from and attach your W-2 and 1099 forms if MD and/or
50
local tax is withheld) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
51
51. 2012 estimated tax payments, amount applied from 2011 return and payment made with Form 502E . . .
52
52. Refundable earned income credit (from worksheet in Instruction 19) . . . . . . . . . . . . . . . . . . . . . . . . . . .
53
53. Enter amount of Maryland tax from line 39 if Pennsylvania resident . . . . . . . . . . . . . . . . . . . . . . . . .
54. Refundable personal income tax credits from Part H, line 6 of Form 502CR (Attach Form 502CR. See
54
Instruction 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
55
55. Total payments and credits (Add lines 50 through 54.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
56. Balance due (If line 49 is more than line 55, subtract line 55 from line 49.) . . . . . . . . . . . . . . . . . . . . . .
56
57. Overpayment (If line 49 is less than line 55, subtract line 49 from line 55.) . . . . . . . . . . . . . . . . . . . . . .
57
58. Amount of overpayment TO BE APPLIED TO 2013 ESTIMATED TAX
58
59
59. Amount of overpayment TO BE REFUNDED TO YOU (Subtract line 58 from line 57.) . . . . . . . . . . . . . . .
REFUND
60. Interest charges from Form 502UP
or for late filing
. . . . . . . . . . . . Total
60
61. TOTAL AMOUNT DUE (Add line 56 and line 60.) IF $1 OR MORE, PAY IN FULL WITH THIS RETURN . . . . .
61
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-
-
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049
Daytime telephone no.
Home telephone no.
CODE NUMBERS (3 digits per box)
Make checks payable and mail to:
Check here
if you authorize your preparer to discuss this return with us. Check here
if you agree to
receive your 1099G Income Tax Refund statement electronically. Under penalties of perjury, I declare that I have
Comptroller of Maryland
examined this return, including accompanying schedules and statements and to the best of my knowledge and
Revenue Administration Division, 110 Carroll Street
belief it is true, correct and complete. If prepared by a person other
than taxpayer, the declaration is based on
Annapolis, Maryland 21411-0001
all information of which the preparer has any knowledge.
(It is recommended that you include your Social Security
number on check using blue or black ink.)
Your signature
Date
Preparer’s PTIN (Required by Law)
Signature of preparer other than taxpayer
Spouse’s signature
Date
Address and telephone number of preparer
COM/RAD-023
12-49

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