INCOME TAX RETURN
NAME _______________________ SSN ________________________
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 .
24. For the direct deposit option, complete the following information clearly and legibly .
24a. Type of account:
CODE NUMBERS (3 digits per box)
Daytime telephone no .
Home telephone no .
Make checks payable and mail to:
here if you authorize your paid preparer not to file electronically . Check
here if you agree to receive
Comptroller of Maryland
your 1099G Income Tax Refund statement electronically . Under penalties of perjury, I declare that I have examined this
Revenue Administration Division
return, including accompanying schedules and statements and to the best of my knowledge and belief it is true, correct and
110 Carroll Street
complete . If prepared by a person other than taxpayer, the declaration is based on all information of which the preparer has
Annapolis, Maryland 21411-0001
any knowledge . Check here
if you authorize your preparer to discuss this return with us .
(It is recommended that you include
your Social Security number on check.)
Preparer’s PTIN (required by law)
Signature of preparer other than taxpayer
Address and telephone number of preparer
WHO MAY USE THIS FORM?
You may use this short form (Form 503) if you answer “NO” to ALL of these questions:
Is your federal adjusted gross income $100,000
Are you claiming a tax credit on Maryland Form
500CR or Form 502CR?
Are you claiming more than two dependents? If
Were you a nonresident of Maryland?
so, you must use Form 502 .
Were you a part-year resident of Maryland?
Do you have a state pickup amount on your Form
Does your return cover less than a 12-month
W-2? If so, you must use Form 502 .
Do you and your spouse both have income subject
Were or are you a fiscal year taxpayer?
to Maryland tax and are filing a joint return? If
yes, you are eligible for the two-income subtraction
Will you want part or all of your refund credited to
modification and must use Form 502 .
next year’s estimated account?
Do you have any other Additions to Income or
Do you have income from an estate or trust or
Subtractions from Income on your Maryland
a pass-through entity from a K-1 or other
return? For example, if you are eligible to take the
statement? If yes, you must use Form 502 .
pension exclusion, you must use Form 502 .
Do you want to itemize deductions?
Did you make estimated payments in 2012; have
part or all of your 2011 refund applied to your
2012 estimated account; or make a payment with
an extension request, Form 502E?