Delaware Form 200-02-X - Non-Resident Amended Personal Income Tax Return - 2013

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DELAWARE
2013
DO NOT WRITE OR STAPLE IN THIS AREA
FORM 200-02-X
NON-RESIDENT AMENDED
Reset
Print Form
PERSONAL INCOME TAX RETURN
or Fiscal year beginning
and ending
Your Social Security No.
Spouse’s Social Security No.
FILING STATUS (MUST CHECK ONE)
Single, Divorced,
Married or Entered into a Civil
1.
3.
Union & Filing Separate Forms
Widow(er)
Your Last Name
First Name and Middle Initial, Jr., Sr., III., etc.
Joint or Entered
Head of
5.
2.
into a Civil Union
Household
Spouse’s Last Name
Spouse’s First Name,
Jr., Sr., III., etc.
Check if FULL-YEAR
Form DE2210 Attached
non-resident in 2013
Present Home Address (Number and Street)
Apt. #
If you were a part-year resident in 2013, give the dates you resided in
Delaware.
City
State
Zip Code
2013
To
2013
From
Month
Day
Month
Day
COMPLETE ALL SECTIONS OF THIS RETURN. NAMES AND SSN’S MUST MATCH ORIGINAL RETURN.
CORRECTED AMOUNTS
1.
DELAWARE ADJUSTED GROSS INCOME....................................................................................................................................
1
00
2.
(a) If you elect the STANDARD DEDUCTION check here..............................................................
a.
Filing Statuses 1, 3 & 5 - $3250
Filing Status 2 - $6500
(b) If you elect to ITEMIZE DEDUCTIONS check here ..................................................................
b.
2
00
ADDITIONAL STANDARD DEDUCTIONS (Not allowed with Itemized Deductions - see instructions)
3.
CHECK BOX(ES)
00
If SPOUSE was 65 or over
and/or Blind
If YOU were 65 or over
and/or Blind
3
TOTAL DEDUCTIONS - ADD LINES 2 and 3 and enter here.........................................................................................................
00
4.
4
5.
TAXABLE INCOME - Subtract Line 4 from Line 1 and compute tax on this amount........................................................................
5
00
6.
Tax Liability Computation
Tax Liability from Tax
A Modified Delaware Sourced Income
00 =
Proration
Rate Table/Schedule
B Delaware Adjusted Gross Income
00 =
.
X
00
6
00
Personal Credits (See Instructions) Enter number of exemptions claimed on Federal return ________ X $110. = ________
7a.
7a
00
Multiply this amount by the proration decimal on Line 6 (X
) and enter total here..........................................................
CHECK BOX(ES) Spouse 60 or Over (if Filing status 2)
7b.
Self 60 or Over
*DF21213019999*
Enter number of boxes checked on Line 7b ________________ X $110. = _______________
7b
00
Multiply this amount by the proration decimal on Line 6 (X
) and enter total here..........................................................
Tax imposed by State of _____________(Part Year Residents only) ................
8.
8
00
8
9.
Other Non-Refundable Credits................................................................................
9
00
9
10. Total Non-Refundable Credits (Add Lines 7a, 7b, 8 and 9)...............................................................................................................
10
00
11.
BALANCE (Subtract Line 10 from Line 6, cannot be less than ZERO)............................................................................................
11
00
12.
Delaware Tax Withheld (W-2's and or 1099's Required)........................................ 12
00
12
00
13.
Estimated Tax Paid & Payments with Extensions...................................................... 13
13
14. S Corp Payments and Refundable Business Credits.....................................................
.
14
14
00
15.
2013 Capital Gains Tax Payments............................................................................. 15
00
15
00
16.
Amount paid (if any, see instructions)........................................................................ 16
16
00
17.
TOTAL Refundable Credits (Add Lines 12, 13, 14, 15 & 16).............................................................................................................
17
00
18.
Refund received (if any, see instructions)..........................................................................................................................................
18
19.
Estimated Tax Carryover and/or Special Funds Contribution as shown on original return ...............................................................
19
00
00
20.
Subtract Lines 18 and 19 from Line 17..............................................................................................................................................
20
00
21.
BALANCE DUE. If Line 11 is more than Line 20, subtract 20 from 11 and enter here.................................. . ........................................................... >
21
22.
OVERPAYMENT. If Line 20 is more than Line 11, subtract 11 from 20 and enter here............................................................ >
22
00
23
00
>
23.
AMOUNT OF LINE 22 TO BE APPLIED TO YOUR ESTIMATED TAX ACCOUNT (See Instructions).....................ENTER
24
24.
PENALTIES AND INTEREST DUE.............................................................................................................................ENTER
>
00
>
25.
NET BALANCE DUE - Enter the amount due (Line 21 plus Lines 23 and 24) and pay in full ...........................PAY IN FULL
25
00
26.
NET REFUND - Subtract Lines 23 and 24 from Line 22......................................................TO BE REFUNDED/ ZERO DUE
>
26
00
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and believe it is true, correct and complete.
YOUR SIGNATURE
TELEPHONE NUMBER
SPOUSE SIGNATURE (If Filing Joint)
DATE
SIGNATURE OF PREPARER
PREPARER’S EIN OR SSN
PREPARER’S PHONE
DATE
STREET ADDRESS OF PREPARER
CITY
STATE
ZIP
REMIT FORM TO:
NET BALANCE DUE (LINE 25): P.O. BOX 8752, WILMINGTON, DE 19899-8752
NET REFUND / ZERO DUE (LINE 26): P.O. BOX 8772, WILMINGTON, DE 19899-8772

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