Fillable Form 503 - Maryland Resident Income Tax Return

MARYLAND RESIDENT

FORM

Page 2

503

INCOME TAX RETURN

2012

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:

Checking

Savings

24b.

24c.

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 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.)

Your signature

Date

Preparer’s PTIN (required by law)

Signature of preparer other than taxpayer

Spouse’s signature

Date

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:

YES NO

1 .

Is your federal adjusted gross income $100,000

8 .

Are you claiming a tax credit on Maryland Form

or more?

500CR or Form 502CR?

2 .

Are you claiming more than two dependents? If

9 .

Were you a nonresident of Maryland?

so, you must use Form 502 .

10 .

Were you a part-year resident of Maryland?

3 .

Do you have a state pickup amount on your Form

11 .

Does your return cover less than a 12-month

W-2? If so, you must use Form 502 .

period?

4 .

Do you and your spouse both have income subject

12 .

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

13 .

Will you want part or all of your refund credited to

modification and must use Form 502 .

next year’s estimated account?

5 .

Do you have any other Additions to Income or

14 .

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 .

6 .

Do you want to itemize deductions?

7 .

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?

COM/RAD-020

12-49

Form 503 - Maryland Resident Income Tax Return - 2012 Page 2

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