Form 502 - Maryland Resident Income Tax Return Page 2

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MARYLAND RESIDENT

FORM

Page 2

502

INCOME TAX RETURN

2012

NAME

SSN

MARYLAND TAX COMPUTATION

21. Amount from line 20 (taxable net income) GO TO TAX TABLE in the Resident instructions . Enter the tax on line 22 . . .21 _____________________________

22. Maryland tax (from Tax Table or Computation Worksheet Schedules I or II) . . . . . . . . . . . . . . . . . . . . . 22 _____________________________

23. Earned income credit (½ of federal earned income credit . See Instruction 18) . . . . . . . . . . . . . . . . . . .

23 _____________________________

24. Poverty level credit (See Instruction 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24 _____________________________

25. Other income tax credits for individuals from Part G, line 8 of Form 502CR (Attach Form 502CR) . . . . . . . 25 _____________________________

26. Business tax credits (Attach Form 500CR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26 _____________________________

27. Total credits (Add lines 23 through 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 _____________________________

28. Maryland tax after credits (Subtract line 27 from line 22) If less than 0, enter 0 . . . . . . . . . . . . . . . . . . 28 _____________________________

LOCAL TAX COMPUTATION

29. Local tax (See Instruction 19 for tax rates and worksheet .) Multiply line 21

by your local tax rate

.__ __ __ __ or use the Local Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . 29 _____________________________

30. Local earned income credit (from Local Earned Income Credit Worksheet in Instruction 19) . . . . . . . . . . . 30 _____________________________

31. Local poverty level credit (from Local Poverty Level Credit Worksheet in Instruction 19) . . . . . . . . . . . . . 31 _____________________________

32. Total credits (Add lines 30 and 31) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 _____________________________

33. Local tax after credits (Subtract line 32 from line 29) If less than 0, enter 0 . . . . . . . . . . . . . . . . . . . . . 33 _____________________________

34. Total Maryland and local tax (Add lines 28 and 33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 _____________________________

35. Contribution to Chesapeake Bay and Endangered Species Fund (See Instruction 20) . . . . . . . . . . . . . . .

35 _____________________________

36. Contribution to Developmental Disabilities Waiting List Equity Fund (See Instruction 20) . . . . . . . . . . . .

36 _____________________________

37. Contribution to Maryland Cancer Fund (See Instruction 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

37 _____________________________

38. Total Maryland income tax, local income tax and contributions (Add lines 34 through 37) . . . . . 38 _____________________________

39. Total Maryland and local tax withheld (Enter total from your W-2 and 1099 forms if MD tax is

withheld and attach) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

39 _____________________________

40. 2012 estimated tax payments, amount applied from 2011 return, payment made

with an extension request, and Form MW506NRS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40 _____________________________

41. Refundable earned income credit (from worksheet in Instruction 21) . . . . . . . . . . . . . . . . . . . . . . . . . .

41 _____________________________

42. Refundable income tax credits from Part H, line 6 of Form 502CR (Attach Form 502CR . See Instruction 21) . . . 42 _____________________________

43. Total payments and credits (Add lines 39 through 42) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 _____________________________

44. Balance due (If line 38 is more than line 43, subtract line 43 from line 38) . . . . . . . . . . . . . . . . . . . . .

44 _____________________________

45. Overpayment (If line 38 is less than line 43, subtract line 38 from line 43) . . . . . . . . . . . . . . . . . . . . .

45 _____________________________

46. Amount of overpayment TO BE APPLIED TO 2013 ESTIMATED TAX . .

46 _______________________

47. Amount of overpayment TO BE REFUNDED TO YOU

REFUND

(Subtract line 46 from line 45) See line 50 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 _____________________________

48. Interest charges from Form 502UP

or for late filing

(See I nstruction 22) Total . . .

48 _____________________________

49. TOTAL AMOUNT DUE (Add lines 44 and 48) IF $1 OR MORE, PAY IN FULL WITH THIS RETURN . . . 49 _____________________________

DIRECT DEPOSIT OF REFUND

(See Instruction 22) Please be sure the account information is correct . For Splitting Direct Deposit, see Form 588 .

In order to comply with banking rules, please check

here if this refund will go to an account outside the United States . If checked, see Instruction 22 .

For the direct deposit option, complete the following information clearly and legibly . 50a. Type of account:

Checking

Savings

50b.

50c.

Routing Number

Account

(9-digits)

number

049

CODE NUMBERS (3 digits per box)

Daytime telephone no .

Home telephone no .

Make checks payable and mail to:

Check here

if you authorize your preparer to discuss this return with us . Check

here if you authorize your paid preparer not to file electronically .

Comptroller of Maryland

Revenue Administration Division

Check

here if you agree to receive your 1099G Income Tax Refund statement electronically . Under penalties of perjury, I declare that I have examined this

110 Carroll Street, Annapolis, Maryland 21411-0001

return, including accompanying schedules and statements and to the best of my knowledge and belief it is true, correct and complete . If prepared by a person other

(It is recommended that you include your

than taxpayer, the declaration is based on all information of which the preparer has any knowledge .

Social Security number on check.)

Your signature

Date

Preparer’s PTIN (required by law)

Signature of preparer other than taxpayer

Spouse’s signature

Date

Address of preparer

Telephone number of preparer

COM/RAD-009