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2013 V irginia Resident Form 760 Individual Income T ax Return Locality Code See instructions Y our first name M.I. Last name Number and Street - If this is a change you must check this box City , town or post office ZIP Code Y our Social Security Number First 4 letters of your last name - - Spouse’ s Social Security Number First 4 letters of spouse’s last name (Reported as taxable on federal return) Forms W -2, W-2G, 1099 and VK-1 reporting VA withholding here. 1. Federal Adjusted Gross Income ................................................................................................. 1 2. T otal Additions from attached Schedule ADJ, Line 3 ................................................................... 2 3. Add Lines 1 and 2 ............................................................... ......................................................... 3 4. Deduction for age on January 1, 2014. See Instructions. Be sure to provide date of birth above. 4 5. Social Security Act and equivalent Tier 1 Railroad Retirement Act benefits ................................ 5 6. State Income Tax refund or overpayment credit (reported as income on federal return) ............... 6 7. Subtractions from attached Schedule ADJ, Line 7 ....................................................................... 7 8. Add Lines 4, 5, 6 and 7 ............................................................... ................................................. 8 9. V irginia Adjusted Gross Income (VAGI) - Subtract Line 8 from Line 3 .................................... 9 10. Deductions- Enter Standard: = $3,000; 2 = $6,000; 3 = $3,000 OR Itemized : 10 1 1. Exemptions. Sum of total from Exe mption Section A multiplied by $930 plus sum of total from Exemption Section B multiplied by $800 ...................................................................................... 1 1 12. .................................... 12 13. Add Lines 10, 1 1 and 12 .............................................................. .............................................. 13 14. V irginia Taxable Income - Subtract Line 13 from Line 9 ........................................................ 14 . , , 0 0 . , , 0 0 . , , 0 0 . , 0 0 Y ou 00 , + = . . Spouse 00 , . , , 0 0 . , , 0 0 . ,, , , 0 0 . , , 0 0 . , , 0 0 . , , 0 0 MINUS 10a. T otal Itemized Deductions 10b. State and Local Income Taxes claimed on Sch. A , , , , . = . 00 00 . , 0 0 . ,, , , 0 0 . , , 0 0 . , , 0 0 Of fice Use (You must attach Schedule ADJ) (You must attach Schedule ADJ) Staple payment here ST APLE ST APLE Last name ST APLE Suf fix Suffix 2601031 01/13 - - (2) Married filing joint return (Enter spouse’ s SSN above) Y es Select a button to indicate status Exemptions Filing Status + + Y ou Spouse Dependents Y ou 65 or over = Spouse 65 or over Y ou Blind Spouse Blind + + + T otal = T otal A B x $930 x $800 = = Add the Dollar Amounts and Enter T otal on Line 11 } File by May 1, 2014 - PLEASE USE BLA CK INK ( From federal return - NOT FEDERAL TAXABLE INCOME ) Date of Birth Y our Birth Date Spouse’ s Birth Date (mm-dd-yyyy) (mm-dd-yyyy) - - - - Check all boxes that apply: Name or filing status has changed since last filing V irginia return was not filed last year Dependent on another’s return Amended Return - Fill in oval if result of NOL I (We) authorize the Dept. of Taxation to discuss my (our) return with my (our) preparer (Not Supported) (Not Supported) (3) Married filing separate return (Enter spouse’ s SSN above) Spouse’s first name M.I. Last name Suffix (1) Single. Did you claim federal head of household? Filing Status 1 Deductions from Virginia Adjusted Gross Income Schedule ADJ, Line 9 State Spouse’s first name (joint returns only) M.I. powered by pdf2json ----------------Page (0) Break---------------- whole 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 dollars below. See instructions. 16 17. Net Amount of Tax - Subtract Line 16 from Line 15 ............................................................... 17 18. Virginia tax withheld for 2013. 18a. Your Virginia withholding ................................................................................................... 18a 18b. Spouse’s Virginia withholding (filing status 2 only) ........................................................... 18b 19. .................................................... 19 (Include overpayment credited from taxable year 2012) 20. Extension Payments (from Form 760IP) ...................................................................................... 20 21. Tax Credit for Low-Income Individuals or Earned Income Credit from attached Sch. ADJ, Line 17 .... 21 22. Credit for Tax Paid to Another State from attached Sch. OSC, Line 21 ...................................... 22 23. Other Credits from attached Schedule CR ................................................................................ 23 24. Add Lines 18a, 18b and 19 through 23 .................................................................................... 24 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) 26. If Line 17 is less than Line 24, subtract Line 17 from Line 24. This is Your Tax Overpayment ... 26 27. Amount of overpayment you want credited to next year’s estimated tax .................................... 27 28. Adjustments and Voluntary Contributions from attached Schedule ADJ, Line 24 ....................... 28 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 31. If Line 26 is greater than Line 29, subtract Line 29 from Line 26. YOUR REFUND .................... 31 . , , 00 16a - Enter Your VAGI below 16b - Enter Spouse’s VAGI below .00 .00 , , , , . 00 . , , 00 . , , 00 . , , 00 . , , , , 00 . , , 00 . , 00 . , , 00 . , , 00 . , , 00 . , , 00 . , , 00 . , , 00 . , , 00 . , , 00 , . , 00 . , , 00 Your SSN Page 2 Form 760 Year 2013 - - (You must attach Schedule ADJ) (You must attach Sch. OSC and a copy of all other state returns) - - - - - - Your business phone number Home phone number Spouse’s business phone number Preparer’s PTIN Firm Name Preparer’s Name Filing Election Phone Number Your Signature Date Spouse’s Signature Date 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. Qualifying farmer, fisherman or merchant seaman Overseas on due date I agree to obtain my Form 1099-G income tax refund statement electronically at www.tax.virginia.gov instead of receiving a paper copy. Primary Taxpayer Deceased Federal Schedule C filed with federal return Spouse Deceased Earned Income Credit from federal return. Amount claimed: , Check all boxes that apply: DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits Bank Routing Transit Number Checking Savings Bank Account Number Choose Direct Deposit or Debit Card Direct Bank Deposit Debit Card (Fees may apply) You authorize the Department to issue a Debit Card if the Direct Deposit section below is not completed. Estimated Tax Paid for taxable year 2013 (from Form 760ES) (If claiming Political Contribution Credit only - check this box - see instructions) CHECK THIS BOX IF PAYING BY CREDIT OR DEBIT CARD - SEE INSTRUCTIONS ----------------Page (1) Break----------------