Form 760PY Fillable 760PY - Part-Year Resident Individual Income Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

(1) Single Use Column A (2) Married Filing Joint Return Use Column A (3) Married Filing Separate Returns Use (4) Married Filing Separately on this Adjustments and Voluntary Contributions from attached Schedule 760PY ADJ Line 24 Amended Return Check if Result of NOL Check here if credit card payment has been made Checking Debit Card (Fees may apply) Dependent on Another s Return Enter spouse's full name on line below For Local Use I (we) authorize the Department of Taxation to discuss Overseas on Due Date Qualifying Farmer Fisherman or Merchant Seaman Your Virginia income tax withheld Attach Forms W 2 W 2G 1099 and VK 1 (Claiming federal Head of Household? YES ) (Even if only one had income) (mm/dd/yyyy) *VA760P113888* *VA760P213888* 2601039 REV 07/13 4a Column A and Spouse's on Line 4b Column A 65 or over A Your Social Security Number Add Lines 1 and 2 Add Lines 13 14 and 15 Add Lines 29 and 30 Add Lines 4a 4b 5 6 7 and 8 Additions from Schedule 760PY ADJ Line 3 ADJUSTED GROSS INCOME from Sch of Income Part 1 Line 7 Column 1 Amount of overpayment on Line 28 to be CREDITED TO 2014 ESTIMATED INCOME TAX and Spouse if and Spouse reported as taxable appropriate column (See Prorated Attach a complete copy of your federal tax return and all other required Virginia attachments B Spouse's Social Security Number Blind Choose Direct Deposit or Debit Card City Town or Post Office Column A (Enter spouse s SSN above) Combined 2013 Estimated Tax Payments (Include credit from 2012) Combined Return Combined Social Security for You Complete the Schedule of Income first and be sure Credits from Schedule CR Section 5 Line 1A If claiming Political Contribution Credit only check box DATE OF BIRTH Dates of VA Residence Deductions from Schedule 760PY ADJ Line 9 Dependents Direct Bank Deposit Domestic Accounts Only Due May 1 2014 Earned Income Credit Claimed on EXEMPTIONS Enter the number Exemptions Worksheet from Schedule Extension Payment Enter amount paid on Form 760IP Federal Return $ 00 federal return and received while a Virginia resident Claim in the same column Filing Election FILING INFORMATION FILING STATUS (CHECK ONLY ONE) Filing Status 2 Filing Status 4 Filing Status 4 ONLY Firm s Name (or Yours if Self Employed) Form 760PY (2013) Page 2 Form760PY 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 I agree to obtain my Form 1099 G income tax refund statement electronically at www tax virginia gov instead of receiving a paper copy If Line 19 is larger than Line 26 enter the difference This is the INCOME TAX YOU OWE Skip to Line 30 If Line 26 is larger than Line 19 enter the difference This is the OVERPAYMENT AMOUNT If Line 28 is larger than Line 31 subtract Line 31 from Line 28 This is the amount to be REFUNDED TO YOU If you owe tax on Line 27 add Lines 27 and 31 OR If Line 28 is an overpayment and Line 31 is larger than Include Spouse if Filing Income attributable to your period of residence outside Virginia from Schedule of income on Federal Return $ 00 Income Part 1 Line 9 Column 3 Itemized Deductions paid while a Virginia resident See instructions Line 28 enter the difference This is the AMOUNT YOU OWE Attach payment Locality Code LTD $ No International Deposits of exemptions being claimed in the of Income Part 2 ) Page 1 Please Sign Preparer s Preparer s Name Preparer s Phone Number Preparer s PTIN Present Home Address (Number and Street or Rural Route) Prorated exemption amount from Schedule of Income Part 2 Line 11 Qualifying Age Deduction Enter Birth Dates above Complete Age Deduction reported as taxable income on federal return and attributable to your period of residence in Virginia Savings See instructions before completing line items Social Security Act and equivalent Tier 1 Railroad Retirement Act benefits Spouse Spouse Spouse From Spouse s Birth Date (mm dd yyyy) Spouse s Business Phone Number Spouse s Signature (If a joint return both must sign) Spouse To SPOUSE'S First Name (filing status 2 or 4) Spouse's Last Name Check if deceased Spouse's Virginia income tax withheld Attach Forms W 2 W 2G 1099 and VK 1 standard deduction from Standard Deductions Worksheet in instructions Staple check or money order here Staple Forms W 2 W 2G 1099 and VK 1 STAPLE HERE State State and local income taxes on Federal Schedule A and included on Line 11 State income tax refund or overpayment credit reported as income on your Status 2 Subtract Line 12 from Line 11 if claiming itemized deductions Otherwise enter Subtractions from Schedule 760PY ADJ Line 7 Suffix Tax amount from Tax Table or Tax Rate Schedule Tax Credit for Low Income Individuals or Virginia Earned Income Credit from Schedule 760PY ADJ Line 17 this return with my (our) preparer to submit it with your Form 760PY Total credit for taxes paid to another state from Schedule OSC Total payments and credits Add Lines 20a 20b 21 22 23 24 and 25 Total Tax Add Line 18 Column A and Line 18 Column B Use Column A: You Column B: Spouse Use Only Va Dept of Taxation Virginia Adjusted Gross Income (VAGI) Subtract Line 9 from Line 3 Virginia Part Year Resident Income Tax Return Virginia Taxable Income Subtract Line 16 from Line 10 when using Filing Status 4 ONLY Otherwise claim Your Age Deduction on Line Worksheet in instructions Enter Spouse's Age Deduction on Line 4b Column B You authorize the Department to issue a Debit Card if the Direct Deposit section below is not completed You From You Include Spouse if you reported the income on Line 1 You To You/Spouse Your Bank Account Number Your Bank Routing Transit Number Your Birth Date (mm dd yyyy) Your Business Phone Number YOUR First Name Your Home Phone Number Your Last Name Check if deceased Your Name Your Signature Your SSN ZIP Code