Form 200-02 - Delaware Individual Non-Resident Income Tax Return - 2016

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2016 NR
DO NOT WRITE OR STAPLE IN THIS AREA
DELAWARE INDIVIDUAL NON-RESIDENT
INCOME TAX RETURN - FORM 200-02
For Fiscal year beginning
and ending
Reset
Your Social Security No.
Spouse’s Social Security No.
Print Form
Your Last Name
First Name and Middle Initial
Jr., Sr., III, etc.
Spouse’s Last Name
Spouse’s First Name,
Jr., Sr., III, etc.
Present Home Address (Number and Street)
Apt. #
City
State
Zip Code
Check if
FILING STATUS (MUST CHECK ONE)
FULL-YEAR
Single, Divorced,
Married or Entered into a Civil
1.
3.
non-resident
Widow(er)
Union & Filing Separate Forms
Form DE2210
If you were a part-year resident in 2016, give the dates you resided in
in 2016
Delaware.
Joint or Entered
Head of Household
2.
5.
From
2016 to
2016
into a Civil Union
Month
Day
Month
Day
Attached
DELAWARE ADJUSTED GROSS INCOME (Begin return on Page 2, Line 1, then enter the amount from Line 30B, Column 1 here ............... >
37.
(a) If you elect the STANDARD DEDUCTION check here ..................................................................................
a.
38.
Filing Statuses 1, 3, & 5 - $3250
Filing Status 2 - $6500
(b) If you elect to ITEMIZE DEDUCTIONS check here and enter amount from reverse side Line 36.................
b.
(Not allowed with Itemized Deductions - see instructions)
ADDITIONAL STANDARD DEDUCTIONS
39.
CHECK BOX(ES) If SPOUSE was 65 or over
and/or blind
If YOU were 65 or over
and/or blind
TOTAL DEDUCTIONS - Add Lines 38 & 39 and enter here ...........................................................................................................................
40.
TAXABLE INCOME - Subtract Line 40 from Line 37, and compute tax on this amount ..................................................................................
41.
42.
Tax Liability Computation
Proration Decimal
Tax Liability from Tax Rate
Table/Schedule Amount
(See instructions, Page 10 )
A Line 30 A
x
B Line 30 B
=
.
PERSONAL CREDITS (If Filing Status 3, see instructions on page 10)
43.
Enter number of exemptions claimed on Federal return
X $110 =
Multiply this amount by the proration decimal on Line 42 (X
) and enter total here
.................................................................
CHECK BOX(ES)
Spouse 60 or over (if filing status 2)
Self 60 or over
43b
Enter number of boxes checked on Line 43b
X $110 =
Multiply this amount by the proration decimal on Line 42 (X
) and enter total here
..................................................................
Tax imposed by state of
44.
(Must attach copy of DE Sch I and other state return)
44
00
(Part-Year Residents Only. See instructions, page 11)
.....................................................................
Other Non-Refundable Credits (see instructions, page 11)
..........................................................................................
45
45.
00
46.
Total Non-Refundable Credits. Add Lines 43a, 43b, 44 and 45 ............................................................................................................................
BALANCE. Subtract Line 46 from Line 42. If Line 46 is greater than Line 42, enter “0” (Zero) ............................................................................
47.
Delaware Tax Withheld
48.
(Attach W-2s/1099s) .............................................................................................................
48
2016 Estimated Tax Paid & Payments with Extensions
...............................................................................................
49
49.
S Corp Payments and Refundable Business Credits (See Instructions, Page 12)
50.
...............................................
50
2016 Capital Gains Tax Payments
51.
(Attach Form 5403) ...........................................................................................
51
TOTAL REFUNDABLE CREDITS. Add Lines 48, 49, 50 and 51
52.
..........................................................................................................................................
If Line 47 is greater than Line 52, subtract 52 from 47 and enter here ................................................................... AMOUNT YOU OWE
>
53.
If Line 52 is greater than Line 47, subtract 47 from 52 and enter here ................................................................... OVERPAYMENT
>
54.
CONTRIBUTIONS TO SPECIAL FUNDS
55.
If electing a contribution, complete and attach DE Schedule III .................................................................................................. TOTAL
>
AMOUNT OF LINE 54 TO BE APPLIED TO 2017 ESTIMATED TAX ACCOUNT ....................................................................... ENTER >
56.
PENALTIES AND INTEREST DUE. If Line 53 is greater than $400, see estimated tax instructions ‘........................................ ENTER >
57.
NET BALANCE DUE. Enter the amount due (Line 53 plus Lines 55 and 57) and pay in full ............................................ PAY IN FULL >
58.
NET REFUND. Subtract Lines 55, 56, and 57 from Line 54 .......................................................... ZERO DUE/TO BE REFUNDED >
59.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and believe it is true, correct, and complete.
Your Signature
Date
Spouse’s Signature (if filing joint)
Date
X
X
Home Phone:
Business Phone:
Email Address:
Signature of Paid Preparer
Date
Address of Paid Preparer
X
Email Address
Business Phone
*DF20316019999*
EIN, SSN, or PTIN
DF20316019999

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