Form 503 - Maryland Resident Tax Return - 2004
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1
2MARYLAND RESIDENT
FORM
2004
503
INCOME TAX RETURN
RESIDENT
$
OR FISCAL YEAR BEGINNING
2004, ENDING
SOCIAL SECURITY #
SPOUSE’S SOCIAL SECURITY #
Your First Name
Last Name
Initial
Spouse’s First Name
Initial
Last Name
PRESENT ADDRESS (No. and street)
Zip Code
City or Town
State
Maryland
City, town or taxing area
Name of county and incorporated city, town or
county
special taxing area in which you were a resident
on the last day of the tax period (See Instructions)
EXEMPTIONS
—
See Instruction 10
Exemption Amount
YOUR FILING STATUS
—
See Instruction 1 to determine if you are required to file.
Enter No.
(A) Yourself
Spouse
(A)
$2,400 $ ___________
Checked
Check here if you are:
Spouse is:
1.
Single
Enter No.
(If you can be claimed on another person’s tax return, use Filing Status 6.)
(B)
(B)
$1,000 $ ___________
Checked
65 or over
Blind
65 or over
Blind
Enter
2.
Married filing joint return or spouse had no income
(C)
$2,400 $ ___________
(C) Dependent Children:
Total
Name(s)
Social Security number(s)
3.
Married filing separately
________________________________ __ __ __-__ __-__ __ __ __
SPOUSE’S SOCIAL SECURITY NUMBER
________________________________ __ __ __-__ __-__ __ __ __
4.
Head of household
65
Enter
(D) Other Dependents:
(D)
$2,400 $ __________
Regular
or over
Total
5.
Qualifying widow(er) with dependent child
Name(s) and Relationship(s)
Social Security number(s)
________________________________ __ __ __-__ __-__ __ __ __
6.
Dependent taxpayer
________________________________ __ __ __-__ __-__ __ __ __
(Enter 0 in Exemption Box (A)—See Instruction 7 )
(E) Enter Total Exemptions (Add A, B, C and D)
(E)
$___________
Total Amount
Dollars
Cents
Print your numbers like this -
- not like this
1
1.
Adjusted gross income from your federal return (See Instruction 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1a
1a. Wages, salaries and/or tips (See Instruction 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
2. Standard deduction (See Instruction 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3. Net income (Subtract line 2 from line 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
4. Exemption amount as computed above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
5. Taxable net income (Subtract line 4 from line 3. GO TO TAX TABLE, page 18.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Place
6
6. Maryland tax (from Tax Table or Computation Worksheet) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
your
7
7a
7b
7. Earned income credit
Poverty level credit
(See Instruction 18) . . . . . . . . .Total
check
or
8
8. Maryland tax after credits (Subtract line 7 from line 6) If less than 0, enter 0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
money
.
0
9
___ ___ ___ ___ . . . . . . . . . . . . . .
9. Local tax (See Instruction 19 for tax rates and worksheet.) Multiply line 5 by your local tax rate
order
10
on top
10a
10. Local: Earned income credit
Poverty level credit
10b
(See Instruction 19) . . . . . .Total
of
11
11. Local tax after credits (Subtract line 10 from line 9) If less than 0, enter 0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
your
12
wage
12. Total Maryland and local tax (Add lines 8 and 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
and
13
13. Contributions to Chesapeake Bay and Endangered Species Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
tax
14
14. Contributions to Fair Campaign Financing Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
state-
15
ments
15. Contributions to Maryland Cancer Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
and
16
16. Total Maryland income tax, local income tax and contributions (Add lines 12 through 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
attach
17
here
17. Total Maryland and local tax withheld (Enter total from and attach your W-2 and 1099 forms if MD tax is withheld) . . . . . . . . . . . . . . .
with
18
18. Refundable earned income credit (from worksheet in Instruction 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ONE
19
19. Total payments and credit (Add lines 17 and 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
staple.
20
20. Balance due (If line 16 is more than line 19, subtract line 19 from line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
REFUND
21. Overpayment (If line 16 is less than line 19, subtract line 16 from line 19) See line 23 . . . . . . . . . . .This is your
22
22. Interest charges from Form 502UP
or for late filing
(See Instruction 22) . . . . . . . . . . .Total
23
23. TOTAL AMOUNT DUE (Add lines 20 and 22) . . . . . . . . . . . . . . IF $1 OR MORE, PAY IN FULL WITH THIS RETURN
For credit card payment check here
and see Instruction 24. Direct debit is available only if you file electronically.
DIRECT DEPOSIT OF REFUND (See Instruction 22) Please be sure the account information is correct.
Checking
Savings
24. To choose the direct deposit option, complete the following information:
24a. Type of account:
24b. Routing number
24c. Account number
049
-
-
-
-
Daytime telephone no.
Home telephone no.
CODE NUMBERS
Make checks payable to: COMPTROLLER OF MARYLAND.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements
Write social security no. on check using blue or black ink.
and to the best of my knowledge and belief it is true, correct and complete. If prepared by a person other than taxpayer, the
Mail to: Comptroller of Maryland, Revenue Administration
declaration is based on all information of which the preparer has any knowledge. Check here
if you authorize your
Division, Annapolis, Maryland 21411-0001
preparer to discuss this return with us.
Your signature
Date
Preparer’s SSN or PTIN
Signature of preparer other than taxpayer
Spouse’s signature
Date
Address and telephone number of preparer
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