MARYLAND NONRESIDENT
FORM
PAGE 2
505
INCOME TAX RETURN
2012
NAME _________________________ SSN _________________________
Dollars
Cents
27
27. Net income (Subtract line 26 from line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
28. Total exemption amount (from EXEMPTIONS area, page 1) See Instruction 10 . . . . . . . . . . . . . . . . . . .
29
29. Enter your AGI factor (from worksheet in Instruction 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
30. Maryland exemption allowance (Multiply line 28 by line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31. Taxable net income (Subtract line 30 from line 27) Figure tax on Form 505NR . . . . . . . . . . . . . . . . . . .
31
MARYLAND TAX COMPUTATION – COMPLETE FORM 505NR BEFORE CONTINUING
32a
32 a. Maryland tax from line 16 of Form 505NR (Attach Form 505NR) . . . . . . . . . . . . . . . . . . . . . . . . . . .
32b
32 b. Special nonresident tax from line 17 of Form 505NR (Attach Form 505NR) . . . . . . . . . . . . . . . . . . . . .
32c
32 c. Total Maryland tax (Add lines 32a and 32b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
33
33. Earned income credit from worksheet in Instruction 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34
34. Poverty level credit from worksheet in Instruction 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35
35. Other income tax credits for individuals from Part G, line 8 of Form 502CR (Attach Form 502CR) . . . . .
36
36. Business tax credits (Attach Form 500CR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
37
37. Total credits (Add lines 33 through 36) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38
38. Maryland tax after credits (Subtract line 37 from line 32c) If less than 0, enter 0 . . . . . . . . . . . . . . . . .
39
39. Contribution to Chesapeake Bay and Endangered Species Fund (See Instruction 21) . . . . . . . . . . . . . .
40
40. Contribution to Developmental Disabilities Waiting List Equity Fund (See Instruction 21) . . . . . . . . . . .
41
41. Contribution to Maryland Cancer Fund (See Instruction 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42
42. Total Maryland income tax and contributions (Add lines 38 through 41) . . . . . . . . . . . . . . . . . . . .
43
43. Total Maryland tax withheld (Enter total from and attach your W-2 and 1099 forms if MD tax is withheld) . .
44
44. 2012 estimated tax payments, amount applied from 2011 return, payments made with Form 502E and Form MW506NRS
45
45. Refundable earned income credit from worksheet in Instruction 20 . . . . . . . . . . . . . . . . . . . . . . . . . .
46
46. Nonresident tax paid by pass-through entities (Attach Maryland Schedule K-1 or other statement) . . . .
47
47. Refundable income tax credits from Part H, line 6 of Form 502CR (Attach Form 502CR . See Instruction 22)
48
48. Total payments and credits (Add lines 43 through 47) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49
49. Balance due (If line 42 is more than line 48, subtract line 48 from line 42) . . . . . . . . . . . . . . . . . . . .
50
50. Overpayment (If line 42 is less than line 48, subtract line 42 from line 48) . . . . . . . . . . . . . . . . . . . .
51
51. Amount of overpayment TO BE APPLIED TO 2013 ESTIMATED TAX . . . . . . . . . . . . . . . . . . . . . . .
52
52. Amount of overpayment TO BE REFUNDED TO YOU (Subtract line 51 from line 50) See line 55
REFUND
53
53. Interest charges from Form 502UP
or for late filing
(See Instruction 23) Total . .
54
54. TOTAL AMOUNT DUE (Add line 49 and line 53) . . . .IF $1 OR MORE, PAY IN FULL WITH THIS RETURN .
DIRECT DEPOSIT OF REFUND (See Instruction 23) 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 23 .
55. For the direct deposit option, complete the following information, clearly and legibly:
55a. Type of account:
Checking
Savings
55b. Routing number
55c. Account
number
(9-digit)
-
-
-
-
049
Daytime telephone no .
Home telephone no .
CODE NUMBERS (3 digits per box)
Make checks payable and mail to:
Check here
if you authorize your preparer to discuss this return with us . Check here
if you authorize your
Comptroller of Maryland, Revenue Administration Division
paid preparer not to file electronically . Check here
if you agree to receive your 1099G Income Tax Refund state-
110 Carroll Street
ment electronically . Under penalties of perjury, I declare that I have examined this return, including accompanying
Annapolis, Maryland 21411-0001
schedules and statements and to the best of my knowledge and belief it is true, correct and complete . If prepared by
(It is recommended that you include your Social Security
a person other than taxpayer, the declaration is based on all information of which the preparer has any knowledge .
number on check using blue or black ink.)
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
COM/RAD-022
12-49