Virginia Resident Form 760 - Individual Income Tax Return - 2012 Page 2

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Page 2

Your SSN
Form 760
-
-
2012
Year
,
,
00
.
15. Amount of Tax from Tax Table or Tax Rate Schedule (round to whole dollars) ...........................15
16. Spouse Tax Adjustment. For Filing Status 2 only. Enter VAGI in whole dollars below. See instructions.
.
00
16a - Enter Your VAGI below
16b - Enter Spouse’s VAGI below
16
LOSS
LOSS
.00
,
,
,
,
.00
,
,
00
.
17. Net Amount of Tax - Subtract Line 16 from Line 15 ...............................................................17
18. Virginia tax withheld for 2012.
.
,
,
00
18a. Your Virginia withholding ...................................................................................................18a
.
,
,
00
18b. Spouse’s Virginia withholding (fi ling status 2 only) ...........................................................18b
,
,
,
,
.
00
19. Estimated Tax Paid for tax year 2012 (from Form 760ES) ...........................................................19
(include overpayment credited from tax year 2011)
,
,
.
00
20. Extension Payments (from Form 760IP) ......................................................................................20
,
.
00
21. Tax Credit for Low Income Individuals or Earned Income Credit from attached Sch. ADJ, Line 17 .....21
,
,
.
00
22. Credit for Tax Paid to Another State from attached Sch. OSC, Line 21 ......................................22
(You must attach Sch. OSC and a copy of all other state returns)
,
,
.
00
23. Other Credits from attached Schedule CR ................................................................................23
(If claiming Political Contribution Credit only - fi ll in oval - see instructions)
,
,
.
00
24. Add Lines 18a, 18b and 19 through 23 ....................................................................................24
,
,
.
00
25. If Line 24 is less than Line 17, subtract Line 24 from Line 17. This is the Tax You Owe ............25
Skip to Line 28
,
,
.
00
26. If Line 17 is less than Line 24, subtract Line 17 from Line 24. This is Your Tax Overpayment ...26
,
,
.
00
27. Amount of overpayment you want credited to next year’s estimated tax ....................................27
,
,
.
00
28. Adjustments and Voluntary Contributions from attached Schedule ADJ, Line 24 .......................28
(You must attach Schedule ADJ)
,
,
.
00
29. Add Lines 27 and 28.....................................................................................................................29
30. If you owe tax on Line 25, add Lines 25 and 29. OR
If Line 26 is less than Line 29, subtract Line 26 from Line 29. AMOUNT YOU OWE ................30
,
,
.
00
-
FILL IN OVAL IF PAYING BY CREDIT OR DEBIT CARD
SEE INSTRUCTIONS
31. If Line 26 is greater than Line 29, subtract Line 29 from Line 26. YOUR REFUND ....................31
,
,
.
00
PAPER REFUND CHECKS WILL NOT BE ISSUED. Choose Debit Card or Direct Deposit below.
DEBIT CARD
DIRECT BANK DEPOSIT
OR
Your bank routing transit number
Type:
Fill in this oval if you want
Checking
to have your refund issued
Account number
Savings
on a prepaid debit card.
Qualifying farmer, fi sherman or merchant seaman
Federal Schedule C fi led with federal return
Fill in all
,
ovals that
Earned Income Credit from federal return. Amount claimed:
Overseas on due date
apply:
Primary Taxpayer Deceased
Spouse Deceased
I (We), the undersigned, declare under penalty of law that I (we) have examined this return and to the best of my (our) knowledge, it is a true, correct and complete return.
Your Signature
Date
Spouse’s Signature
Date
Your business phone number
Home phone number
Spouse’s business phone number
-
-
-
-
-
-
Filing
Preparer’s PTIN
Preparer’s Name
Firm Name
Phone Number
Election

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