Form 760py - Virginia Part-Year Resident Income Tax Return - 2010

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STAPLE HERE
*VA760P110000*
Form
2010
Virginia Part-Year Resident Income Tax Return
760PY
Due May 2, 2011
Page 1
See instructions before completing line items.
Dates of VA Residence
Attach a complete copy of your federal tax return and all other required Virginia attachments.
(mm/dd/yyyy)
A
YOUR
Check if deceased
Your Social Security Number
mI
Your Last Name
Suffix
You - From
You - To
First Name
B
SPOUSE'S
Check if deceased
Spouse's Social Security Number
mI
Spouse's Last Name
Suffix
Spouse - From
Spouse - To
First Name (filing status 2 or 4)
Present Home Address (Number and Street, or Rural Route)
city, Town or Post Office
State
ZIP code
Locality code
Your Business Phone Number
Your Home Phone Number
Spouse’s Business Phone Number
Preparer’s FEIN/PTIN/SSN
Filing Election
code
FILING STATUS (ChECK ONLY ONE)
EXEMPTIONS - Enter the number
FILING INFORMATION
of exemptions being claimed in the
Amended Return - check if Result of NOL
appropriate column. (See Prorated
(1) Single
- use column A
Exemptions Worksheet from Schedule
(claiming federal Head of Household? YES
)
Overseas on due date
of Income, Part 2.)
dependent on Another’s Return
(2) Married, Filing Joint Return
B
A
- use column A
(Even if only one had income)
Spouse
You
Qualifying Farmer, Fisherman or merchant Seaman
Filing Status 4
and Spouse if
(3) Married, Filing Separate Returns -
use
ONLY
Filing Status 2
I (we) authorize the department of Taxation to discuss
column A (Enter spouse’s SSN above)
this return with my (our) preparer.
You/Spouse
Enter s
pouse's full name on line below
Earned Income credit claimed on
___________________________________
dependents
Federal Return ............................ $ ________________.00
(4) Married, Filing Separately on this
65 or over
combined Social Security for You
Combined Return
and Spouse reported as taxable
use column A: You - column B: Spouse
Blind
income on Federal Return .......... $ ________________.00
You
B
A
Spouse
Complete the Schedule of Income first and be sure
Include Spouse if Filing
Filing Status 4 ONLY
Status 2
to submit it with your Form 760PY.
1
1 AdjuSTEd GROSS INcOmE from Sch. of Income, Part 1, Line 7, column 1 ...
00
00
2
2 Additions from Schedule 760PY Adj, Line 3. ......................................................
00
00
3
3 Add Lines 1 and 2. ..............................................................................................
00
00
4 Qualifying age deduction. complete Age
You
deduction Worksheet in instructions. Enter
/
/
4a
Birth date
Spouse's Age deduction on Line 4b, column
00
(mm/dd/yyyy)
B when using Filing Status 4 ONLY. Otherwise,
Spouse
claim Your Age deduction on Line 4a, column
/
/
4b
Birth date
A and Spouse's on Line 4b, column A.
00
00
(mm/dd/yyyy)
5 Social Security Act and equivalent Tier 1 Railroad Retirement Act benefits
reported as taxable income on federal return and attributable to your period of
5
residence in Virginia. .............................................................................................
00
00
6 State income tax refund or overpayment credit reported as income on your
federal return and received while a Virginia resident. claim in the same column
6
you reported the income on Line 1. ......................................................................
00
00
7 Income attributable to your period of residence outside Virginia from Schedule
7
of Income, Part 1, Line 9, column 3. ....................................................................
00
00
8
8 Subtractions from Schedule 760PY Adj, Line 7. .................................................
00
00
9
9 Add Lines 4a, 4b, 5, 6, 7 and 8...........................................................................
00
00
10
10 Virginia Adjusted Gross Income (VAGI). Subtract Line 9 from Line 3. ..........
00
00
For Local use
coding
2601039 Rev. 08/10
LTD
v

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