Form 200-02 - Delaware Individual Non-Resident Income Tax Return - De Division Of Revenue - 2001 Page 2

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2001 DELAWARE NON-RESIDENT FORM 200-02, PAGE 2
Delaware Source
Federal
Income/Loss
COLUMN 1
COLUMN 2
SECTION A - INCOME AND ADJUSTMENTS FROM FEDERAL RETURN
1.
Wages, salaries, tips, etc.................................................................................................................
1
2.
Interest..............................................................................................................................................
2
3.
Dividends..........................................................................................................................................
3
4.
State refunds, credits or offsets of state & local income taxes.......................................................
4
5.
Alimony received..............................................................................................................................
5
6.
Business income or (loss) (See instructions)..................................................................................
6
7a.
Capital gain or (loss)........................................................................................................................ 7a
7b.
Other gains or (losses)..................................................................................................................... 7b
8.
IRA distributions...............................................................................................................................
8
9.
Taxable pensions and annuities......................................................................................................
9
10.
Rents, royalties, partnerships, S corps, estates, trusts, etc............................................................ 10
11.
Farm income or (loss)...................................................................................................................... 11
12.
Unemployment compensation (insurance)...................................................................................... 12
13.
Taxable Social Security Benefits..................................................................................................... 13
14.
Other income (state nature and source)
14
15.
Total income. Add Lines 1 through 14............................................................................................ 15
16.
Total Federal Adjustments (See instructions).................................................................................
16
17.
Federal Adjusted Gross Income for Delaware purposes. Subtract Line 16 from 15..................... 17
SECTION B - DELAWARE MODIFICATIONS AND ADJUSTMENTS - ADDITIONS ( + )
COLUMN 1
COLUMN 2
18.
Interest received on obligations of any state other than Delaware................................................
18
19.
Fiduciary adjustment, oil depletion.................................................................................................. 19
20.
TOTAL - Add Lines 18 & 19............................................................................................................
20
21.
Add Lines 17 & 20...........................................................................................................................
21
SECTION C - DELAWARE MODIFICATIONS AND ADJUSTMENTS - SUBTRACTIONS ( - )
COLUMN 1
COLUMN 2
22.
Interest received on U.S. Obligations.............................................................................................. 22
23.
Pension Exclusion/Retirement Exclusion (See instructions)..........................................................
23
24.
Delaware State tax refund, Delaware Lottery.................................................................................. 24
25.
Fiduciary Adjustment, Work Opportunity Credit, Delaware NOL Carryforward.............................. 25
26.
Taxable Social Security Benefits/Railroad Retirement Benefits/Higher Education Exclusion....... 26
27.
TOTAL - Add Lines 22 through 26................................................................................................... 27
28.
Subtract Line 27 from Line 21 and enter here................................................................................. 28
29.
Exclusion for certain persons 60 and over or disabled (See instructions).....................................
29
30A. Column 2. Subtract Line 29 from Line 28. This is your modified Delaware Source Income.
30A
Enter on Line 42, Box A.................................................................................................................
30B. Column 1. Subtract Line 29 from Line 28. This is your Delaware Adjusted Gross Income.
Enter on Line 37, page 1 and on Line 42, Box B........................................................................ 30B
SECTION D - ITEMIZED DEDUCTIONS (ATTACH FEDERAL SCHEDULE A, FORM 1040)
COLUMN 1
31.
Enter total Itemized Deductions (See instructions)......................................................................... 31
32.
Enter Foreign Taxes Paid (See instructions)................................................................................... 32
33.
Enter Charitable Mileage Deduction (See instructions).................................................................. 33
34.
Self-Employed Health Insurance Deduction (See instructions).....................................................
34
34a. TOTAL - Add Lines 31, 32, 33 and 34............................................................................................ 34a
35a. Enter State Income Tax included in Line 31 above (See Instructions).......................................... 35a
35b. Enter Form 700 Tax Credits (Charitable Contributions) (See instructions)................................... 35b
36.
Subtract Line 35a and 35b from Line 34a. Enter here and on front, Line 38................................ 36
If you would like your refund deposited directly to your checking or savings account, complete
SECTION E - DIRECT DEPOSIT INFORMATION
boxes a, b and c below. See instructions for details.
a. Routing Number
b. Type:
Checking
Savings
c. Account Number
If a 2D barcode (black and white box) appears in the upper right corner of page 1 of this form, send the return to one of the following addresses:
MAKE CHECKS PAYABLE AND MAIL TO: DELAWARE DIVISION OF REVENUE, P.O. BOX 8753, WILMINGTON, DELAWARE 19899-8753
MAIL REFUND DUE RETURNS TO:
DELAWARE DIVISION OF REVENUE, P.O. BOX 8710, WILMINGTON, DELAWARE 19899-8710
MAIL ZERO DUE RETURNS TO:
DELAWARE DIVISION OF REVENUE, P.O. BOX 8711, WILMINGTON, DELAWARE 19899-8711
If a 2D barcode (black and white box) DOES NOT appear in the upper right corner of page 1 of this form, send the return to one of the following addresses:
MAKE CHECKS PAYABLE AND MAIL TO: DELAWARE DIVISION OF REVENUE, P.O. BOX 8752, WILMINGTON, DELAWARE 19899-8752
MAIL REFUND DUE RETURNS TO:
DELAWARE DIVISION OF REVENUE, P.O. BOX 8772, WILMINGTON, DELAWARE 19899-8772
MAIL ZERO DUE RETURNS TO:
DELAWARE DIVISION OF REVENUE, P.O. BOX 8711, WILMINGTON, DELAWARE 19899-8711
MAKE CHECKS PAYABLE TO: DELAWARE DIVISION OF REVENUE
REMEMBER TO ATTACH APPROPRIATE SUPPORTING SCHEDULES WHEN FILING YOUR RETURN
(VENDOR ID#
) (Rev 08/27/01)

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