Form 760py - Virginia Schedule Of Income - 2014
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1
22014 VIRGINIA SCHEDULE OF INCOME
*VAPYIN114888*
Form 760PY
Page 1
Your Name
Your SSN
PART 1
Income Distribution
Complete the Schedule of Income prior to beginning Form 760PY. Everyone should complete Section A. If you are claiming
filing status 4, also complete Section B. Refer to your federal return when completing Part 1.
SECTION A
You (Include Spouse if Filing Status 2)
SCHEDULE OF INCOME
Column A1
Column A2
Column A3
Form 760PY, Column A
Federal Return
While VA Resident
While NOT VA Resident
— All Filers Must Complete This Schedule —
1.
Wages, salaries, tips, etc. .....................................
1
.00
.00
.00
2.
Interest and dividends ..........................................
2
.00
.00
.00
3.
Pension and other income ....................................
3
.00
.00
.00
4.
Gross income (add Lines 1, 2 and 3) ...................
4
.00
.00
.00
5.
Adjustments to income: moving expenses ...........
5
.00
.00
.00
6.
Other income adjustments (attach explanation) ...
6
.00
.00
.00
7.
Adjusted gross income
7
.00
.00
.00
(Line 4 less Lines 5 and 6)* ..................................
8.
Net fixed date conformity modifications ................
8
.00
.00
.00
9.
Fixed date conformity Federal Adjusted Gross
9
.00
.00
.00
Income (add Lines 7 and 8) ..................................
*Enter the amount from Line 7, Column A1 on Form 760PY, Page 1, Line 1, Column A.
SECTION B
Enter Spouse’s Income When Filing Status 4 Is Claimed
SCHEDULE OF INCOME
Column B1
Column B2
Column B3
Form 760PY, Column B
Federal Return
While VA Resident
While NOT VA Resident
— Spouse Must Complete This Schedule if claiming Filing Status 4 —
1. Wages, salaries, tips, etc. .....................................
1
.00
.00
.00
2. Interest and dividends ..........................................
2
.00
.00
.00
3. Pension and other income ....................................
3
.00
.00
.00
4. Gross income (add Lines 1, 2 and 3) ...................
4
.00
.00
.00
5. Adjustments to income: moving expenses ...........
5
.00
.00
.00
6. Other income adjustments (attach explanation) ...
6
.00
.00
.00
7. Adjusted gross income
7
.00
.00
.00
(Line 4 less Lines 5 and 6)**.................................
8. Net fixed date conformity modifications ................
8
.00
.00
.00
9. Fixed date conformity Federal Adjusted Gross
9
.00
.00
.00
Income (add Lines 7 and 8) ..................................
**Enter the amount from Line 7, Column B1 on Form 760PY, Page 1, Line 1, Column B.
Submit completed Schedule of Income with Form 760PY to avoid delays.
2601301 Rev 08/14
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