Delaware Form 200-02-X - Non-Resident Amended Personal Income Tax Return - 2013 Page 2
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1
2FORM 200-02-X
2013
Page 2
*DF21213029999*
NON-RESIDENT AMENDED
PERSONAL INCOME TAX RETURN
NOTE: IF YOUR ORIGINAL RETURN WAS FILED USING TWO SEPARATE FORMS, YOU MUST FILE TWO SEPARATE AMENDED FORMS
IS AN AMENDED FEDERAL RETURN BEING FILED?.........................................................................................................
YES
NO
IF NO, PLEASE EXPLAIN. IF THE CHANGES PERTAIN TO THE DE RETURN ONLY, LIST THE LINE NUMBERS BEING AMENDED.
YES
NO
HAS THE DELAWARE DIVISION OF REVENUE ADVISED YOU YOUR ORIGINAL RETURN IS BEING AUDITED?.........
IS THIS AMENDED RETURN BEING FILED AS A PROTECTIVE CLAIM?........................................................................
YES
NO
A DETAILED EXPLANATION OF ALL CHANGES MUST BE PROVIDED IN THIS SPACE. ALL SUPPORTING SCHEDULES AND/OR DOCUMENTATION MUST BE ATTACHED
.
Federal
DE Source Income/Loss
SECTION A - INCOME AND ADJUSTMENTS FROM FEDERAL RETURN
COLUMN 1
COLUMN 2
27
00
00
27.
Wages, salaries, tips, etc................................................................................................................................
28
00
00
28.
Interest.............................................................................................................................................................
29
00
00
29.
Dividends.........................................................................................................................................................
30
00
00
s of state & local income taxes.................................................................
31
00
00
31.
Alimony received............................................................................................................................................
32
32.
Business income or (loss) (See instructions)...............................................................................................
00
00
33a
00
00
33a. Capital gain or (loss)......................................................................................................................................
33b
33b. Other gains or (losses)...................................................................................................................................
00
00
34
34.
IRA distributions............................................................................................................................................
00
00
35
35.
Taxable pensions and annuities...................................................................................................................
00
00
36
36.
Rents, royalties, partnerships, S corps, estates, trusts, etc.......................................................................
00
00
37
37.
Farm income or (loss)....................................................................................................................................
00
00
38
38.
Unemployment compensation (insurance).................................................................................................
00
00
39
s...................................................................................................................
00
00
40
40.
Other income (state nature and source)
00
00
41.
Total income. Add Lines 27 through 40......................................................................................................
41
00
00
42.
Total Federal Adjustments (See instructions)............................................................................................
42
00
00
43.
Federal Adjusted Gross Income for Delaware purposes. Subtract Line 42 from 41...............................
43
00
00
SECTION B - DELAWARE MODIFICATIONS AND ADJUSTMENTS - ADDITIONS ( + )
COLUMN 1
COLUMN 2
44
44.
Interest received on obligations of any state other than Delaware........................................................
00
00
45
00
00
45.
Fiduciary adjustment, oil depletion............................................................................................................
46
46.
TOTAL - Add Lines 44 & 45...........................................................................................................................
00
00
47
47.
Add Lines 43 & 46..........................................................................................................................................
00
00
COLUMN 1
COLUMN 2
SECTION C - DELAWARE MODIFICATIONS AND ADJUSTMENTS - SUBTRACTIONS ( - )
48
00
00
48.
Interest received on U.S. Obligations..........................................................................................................
49
00
00
49.
Pension/Retirement Exclusions (See instructions) ..................................................................................
50
00
00
50.
Delaware State t ax refund . ................................. . ........................... . .................................................................
51
00
00
51.
Fiduciary Adjustment, Work Oppor tunity Credit, Delaware NOL Carryforward.....................................
52
00
00
53.
TOTAL - Add Lines 48 through 52................................................................................................................
53
00
00
54.
Subtract Line 53 from Line 47 and enter here............................................................................................
54
00
00
55.
Exclusion for certain persons 60 and over or disabled (See instructions)..............................................
55
00
00
Column 2.
56A.
Enter on front side Line 6, Box A
......................................................................................................................................................
00
56A
Column 1. Subtract Line 55 from Line 54. This is your Delaware Adjusted Gross Income.
56B.
00
56B
Enter on front side Line 1 and Line 6, Box B .
..........................................................................................
COLUMN 1
SECTION D - ITEMIZED DEDUCTIONS (ATTACH FEDERAL SCHEDULE A, FORM 1040)
00
57
57. Enter total Itemized Deductions (If Filing Status 3, see instructions) ....................................................
00
58
58. Enter Foreign Taxes Paid (See instructions)................................................................................................
00
59. Enter Charitable Mileage Deduction (See instructions).............................................................................
59
60. TOTAL - Add Lines 57, 58, and 59 ................................................................................................................
00
60
61a. Enter State Income Tax included in Line 57 above (See Instructions)....................................................
00
61a
61b. Enter Form 700 Tax Credit Adjustment (See instructions)........................................................................
00
61b
62.
Subtract Line 61a and 61b from Line 60. Enter here and on front, Line 2..............................................
00
62
Toll-free telephone number (Delaware only) 1-800-292-7826
(Rev 10/24/13)
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