Delaware Resident Form 200-01 - Delaware Individual Resident Income Tax Return - 2012 Page 3
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32012 DELAWARE RESIDENT SCHEDULES
Name(s):
Social Security Number:
COLUMNS: Column A is reserved for the spouse of those couples choosing filing status 4. (Reconcile your Federal totals to the appropriate
individual. See Page 9 worksheet.) Taxpayers using filing statuses 1, 2, 3, or 5 are to complete Column B only.
Filing Status 4 ONLY
All other filings statuses
Spouse Information
You or You plus Spouse
DE SCHEDULE I - CREDIT FOR INCOME TAXES PAID TO ANOTHER STATE
COLUMN A
COLUMN B
.
See the instructions and complete the worksheet on Page 7 prior to completing DE Schedule I
Enter the credit in HIGHEST to LOWEST amount order.
00
00
1
1. Tax imposed by State of
(enter 2 character state name)..................................
00
00
2
2. Tax imposed by State of
(enter 2 character state name)..................................
00
00
3
3. Tax imposed by State of
(enter 2 character state name)..................................
00
00
4
4. Tax imposed by State of
(enter 2 character state name)..................................
00
00
5. Tax imposed by State of
(enter 2 character state name)..................................
5
6.
Enter the total here and on Resident Return, Line 10.
You must attach a copy of the
00
00
other state return(s) with your Delaware tax
return.....................................................
6
DE SCHEDULE II - EARNED INCOME TAX CREDIT (EITC)
Complete the Earned Income Tax Credit for each child YOU CLAIMED the Earned Income Credit for on your federal return.
CHILD 2
CHILD 1
CHILD 3
Qualifying Child Information
7. Child’s Name (First and Last Name)..................
7
8. Child’s SSN .......................................................
8
9. Child’s Year of Birth............................................
9
10. Was the child under age 24 at the end of 2012,
YES
NO
YES
NO
YES
NO
a student, and younger than you (or your
10
spouse, if filing jointly)?.....................................
11. Was the child permanently and totally disabled
YES
NO
YES
NO
YES
NO
11
during any part of 2012?...................................
00
12.
Delaware State Income Tax from Line 8 (enter higher tax amount from Column A or B)
..........
12
13. Federal earned income credit from Federal Form 1040, Line 64a;
00
Form
1040A, Line 38a; or Form 1040EZ, Line 8a
........................................................................
13
14. Delaware EITC Percentage (20%)............................................................................................
.20
14
15. Multiply Line 13 by Line 14......................................................................................................
15
00
16. Enter the Smaller of Line 12 or Line 15 above. Enter here and
00
on Resident Return, Line 14.......................................................................................................
16
See the instructions on Page 8 for ALL required documentation to attach.
DE SCHEDULE III - CONTRIBUTIONS TO SPECIAL FUNDS
See Page 13 for a description of each worthwhile fund listed below.
17.
Non-Game Wildlife
00
A
.
Diabetes Educ.
00
00
F
.
Ovarian Cancer Fund
K
.
U.S. Olympics
00
B
.
Veteran’s Home
00
00
21st Fund for Children
G
.
L
.
C
.
Emergency Housing
00
00
DE National Guard
White Clay Creek
00
H
.
M
.
Juv. Diabetes Fund
I
.
Home of the Brave
D
.
Breast Cancer Educ.
00
00
00
N
.
Mult. Sclerosis Soc.
00
Organ Donations
J
.
00
Senior Trust Fund
E
.
00
O
.
00
Enter the total Contribution amount here and on Resident Return, Line 24 ................................
17
This page MUST be sent in with your Delaware return if any of the schedules (above) are completed.
*DF20212019999*
(Rev 11/26/12)
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