Form 510 - Maryland Pass-Through Entity Income Tax Return - 2012 Page 3
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132012
MARYLAND PASS-THROUGH ENTITY
FORM
510
INCOME TAX RETURN MEMbERS’
INFORMATION
SCHEDULE b
Name shown on Form 510
Federal employer identification number (9 digits)
PART I – INDIVIDUAL MEMbERS’ INFORMATION
Enter the information in Social Security Number Order
Check
Distributive or
Distributive or
Distributive or pro
here if
Social Security Number and
pro rata share of
pro rata share
rata share of tax
Address
Maryland:
name of member
income
of tax paid (See
credit
(See Instructions)
Instructions)
(See Instructions)
Non-
Resident
Resident
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SUBTOTAL from additional Form 510 Schedule B for individual members
TOTAL:
COM/RAD 069
12-49
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