Form 505x - Maryland Nonresident Amended Tax Return - 2011 Page 2

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MARYLAND FORM 505X, Page 2
2011
NAME ________________________________ SSN _______________________________
I. INCOME AND ADJUSTMENTS TO INCOME: You must complete the following using the amounts from your federal income
tax return. If there are no changes to the amounts claimed on your original Maryland return, check here  and complete
11505X150
Column A and line 17 of Column C.
A. Federal income
C. Non-Maryland income
Maryland income
INCOME AND ADJUSTMENTS INFORMATION
(Loss)
(Loss)
(Loss)
as corrected
as corrected
as corrected
(See Instruction 4)
1. Wages, salaries, tips, etc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Taxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3. Dividend income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4. Taxable refunds, credits or offsets of state and local income taxes . . . . . . . . . 4
5. Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6. Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7. Capital gain or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8. Other gains or (losses) (from federal Form 4797) . . . . . . . . . . . . . . . . . . . . . . 8
9. Taxable amount of pensions, IRA distributions, and annuities . . . . . . . . . . . . . 9
10. Rents, royalties, partnerships, estates, trusts, etc . (Circle appropriate item) . 10
11. Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12. Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13. Taxable amount of social security and tier 1 railroad retirement benefits . . . 13
14. Other income (including lottery or other gambling winnings) . . . . . . . . . . . . 14
15. Total income (Add lines 1 through 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16. Total adjustments to income from federal return (IRA, alimony, etc .) . . . . . . 16
17. Adjusted gross income (Subtract line 16 from 15) (Carry the amount
from line 17, column A, to page 1, line 1, column C) . . . . . . . . . . . . . . . . . . 17
II. ITEMIzED DEDUCTIONS: If you itemized deductions on your Maryland return, you must complete the following. If there are no
changes to the amounts claimed on your original Maryland return, check here  and complete Column A and line 11 of Column C.
A. As originally
B. Net increase
C. Corrected amount
reported or as
or (decrease)
previously adjusted
1. Medical and dental expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4. Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5. Casualty or theft losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6. Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7. Enter total itemized deductions from federal Schedule A . . . . . . . . . . . . . . . . . . 7
8. Enter state and local income taxes included on line 2 or from worksheet
(See Instruction 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9. Net deductions (Subtract line 8 from line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10. AGI factor (See instruction 14 of the nonresident instructions) . . . . . . . . . . . . . . . . 10
11. Total Maryland deductions (multiply line 9 by line 10) (Enter on page 1,
in each appropriate column of line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
III. EXPLANATION OF CHANGES TO INCOME, DEDUCTIONS AND CREDITS: Enter the line number from page 1 for each item
you are changing and give the reason for each change. Attach any required supporting forms and schedules for items changed.
Check here  if you authorize your preparer to discuss this return with us.
Make checks payable and mail to: COMPTROLLER OF MARYLAND
Revenue Administration Division, 110 Carroll Street
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the
Annapolis, Maryland 21411-0001
best of my knowledge and belief it is true, correct and complete. If prepared by a person other than taxpayer, the declaration is based
(It is recommended that you write your Social Security number
on all information of which the preparer has any knowledge.
on your check in blue or black ink.)
Your signature
Date
Signature of preparer other than taxpayer
Preparer’s SSN or PTIN (Required by Law)
Spouse’s signature
Date
Address and telephone number of preparer
COM/RAD 022A
11-50

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