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

Form 760PY (2013)

*VA760P213888*

Page 2

Your Name

Your SSN

Spouse

You

Include Spouse if

Filing Status 4 ONLY

Filing Status 2

11 Itemized Deductions paid while a Virginia resident. See instructions ..............

12 State and local income taxes on Federal Schedule A and included on Line 11.

13 Subtract Line 12 from Line 11 if claiming itemized deductions. Otherwise, enter

standard deduction from Standard Deductions Worksheet in instructions. ..........

14 Prorated exemption amount from Schedule of Income, Part 2, Line 11. ..............

15 Deductions from Schedule 760PY ADJ, Line 9. ...................................................

16 Add Lines 13, 14 and 15. ....................................................................................

17 Virginia Taxable Income. Subtract Line 16 from Line 10. ...............................

18 Tax amount from Tax Table or Tax Rate Schedule. ..............................................

19 Total Tax. Add Line 18, Column A and Line 18, Column B. ............................................................................

20a

20a Your Virginia income tax withheld. Attach Forms W-2, W-2G, 1099 and VK-1 .....................................................

20b

20b Spouse's Virginia income tax withheld. Attach Forms W-2, W-2G, 1099 and VK-1 .............................................

Combined 2013 Estimated Tax Payments (Include credit from 2012). .................................................................

Extension Payment - Enter amount paid on Form 760IP. .....................................................................................

Tax Credit for Low-Income Individuals or Virginia Earned Income Credit from Schedule 760PY ADJ, Line 17. ..

Total credit for taxes paid to another state from Schedule OSC...........................................................................

Credits from Schedule CR, Section 5, Line 1A. If claiming Political Contribution Credit only, check box. .....

Total payments and credits. Add Lines 20a, 20b, 21, 22, 23, 24 and 25. ......................................................

If Line 19 is larger than Line 26, enter the difference. This is the INCOME TAX YOU OWE. Skip to Line 30 .....

If Line 26 is larger than Line 19, enter the difference. This is the OVERPAYMENT AMOUNT. ...........................

Amount of overpayment on Line 28 to be CREDITED TO 2014 ESTIMATED INCOME TAX. ...................................

Adjustments and Voluntary Contributions from attached Schedule 760PY ADJ, Line 24. ..................................

Add Lines 29 and 30. ..........................................................................................................................................

If you owe tax on Line 27, add Lines 27 and 31 - OR - If Line 28 is an overpayment and Line 31 is larger than

Line 28, enter the difference. This is the AMOUNT YOU OWE. Attach payment.

Check here if credit card payment has been made. ...............................................................................

If Line 28 is larger than Line 31, subtract Line 31 from Line 28. This is the amount to be REFUNDED TO YOU. ......

Debit Card (Fees may apply)

Choose Direct Deposit or Debit Card

Direct Bank Deposit

You authorize the Department to issue a Debit Card if the Direct Deposit section below is not completed.

Checking

Savings

DIRECT BANK DEPOSIT

Your Bank Routing Transit Number

Your Bank Account Number

Domestic Accounts Only.

No International Deposits.

I agree to obtain my Form 1099-G income tax refund statement electronically at instead of receiving a paper copy.

I (We), the undersigned, declare under penalty of law that I (we) have examined this return and to the best of my (our) knowledge, it is a true, correct and complete return.

Date

Your Signature

Please Sign

Here

Spouse’s Signature (If a joint return, both must sign)

Date

Preparer’s Name

Date

Preparer’s

Use Only

Firm’s Name (or Yours if Self-Employed)

Preparer’s Phone Number