*VA0760115888*
2015 Virginia Resident Form 760
Individual Income Tax Return
File by May 2, 2016 - PLEASE USE BLACK INK
- - - Do you need to file? See Line 9 and Instructions - - -
1. Adjusted Gross Income from federal return - Not federal taxable income .......................................1
2. Additions from enclosed Schedule ADJ, Line 3. ...................................................................................2
3. Add Lines 1 and 2 ................................................................................................................................3
4. Age Deduction. See Instructions. Be sure to provide date of birth above.
4
5. Social Security and equivalent Tier 1 Railroad Retirement benefits if taxable on federal return ...........5
6. State Income Tax refund or overpayment credit (reported as income on federal return) ......................6
7. Subtractions from enclosed Schedule ADJ, Line 7 ..............................................................................7
8. Add Lines 4, 5, 6 and 7 ........................................................................................................................8
9. Virginia Adjusted Gross Income (VAGI) - Subtract Line 8 from Line 3. Enter the result on this line.
Note: If less than $11,950 for Filing Status 1 or 3; or $23,900 for Filing Status 2, your tax is $0.00 ....9
10. Itemized Deductions from federal return .............................................................................................10
11. State and Local Income Taxes claimed on federal Schedule A ...........................................................11
12. Subtract Line 11 from Line 10 if claiming itemized deductions. Otherwise, enter standard deduction:
Filing Status: 1 = $3,000; 2 = $6,000; 3 = $3,000 ................................................................................12
13. Exemptions. Sum of total from Exemption Section A plus Exemption Section B .................................13
14. Deductions from Schedule ADJ, Line 9 ...............................................................................................14
15. Add Lines 12, 13 and 14 ....................................................................................................................15
16. Virginia Taxable Income - Subtract Line 15 from Line 9 ................................................................16
2601031
11/15
Social Security Number
Filing Status Enter in box (1 = Single, 2 = Joint, and 3 = Married Filing Separately)
Your first name M.I.
Last name including suffix
Spouse’s first name (joint returns only) M.I.
Last name including suffix
Number and Street - If this is a change, you must fill in oval
City, town or post office and state
ZIP Code
Fill in all ovals that apply:
Name or Filing Status changed
Virginia return not filed last year
Dependent on another’s return
Qualifying farmer, fisherman or
merchant seaman
Amended Return - Result of NOL? YES
Overseas on due date
Federal Schedule C filed
Earned Income Credit on federal return
Amount claimed:
Code
Birth Date (mm-dd-yyyy)
Deceased
First 4 letters
of last name
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Locality
Code
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Office Use
$_________
LTD LAR DLAR DTD
Exemptions Add Sections A and B. Enter the sum on Line 13.
+ + + = X $800 =
Spouse 65
or over
You 65
or over
Spouse
Blind
You
Blind
+ + = X $930 =
1
Total Section A
Spouse if
Filing Status 2
You
Dependents
Last 5 Digits of VA Driver’s License ID
You Spouse
=
Spouse
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,
. 00
,
You
You
Spouse
Federal head of household? YES
If Filing Status 3, enter spouse's SSN in the Spouse's Social Security Number
box at top of form and enter Spouse’s Name_______________________________
You
Spouse
Total Section B
WEB
*VA0760215888*
Page 2
2015 Form 760
Your SSN
DIRECT BANK DEPOSIT
Domestic Accounts Only.
No International Deposits.
Bank Routing Transit Number
Checking
Savings
Bank Account Number
If the Direct Deposit section below is not completed, your refund will be issued by check.
17. Amount of Tax from Tax Table or Tax Rate Schedule (round to whole dollars) ...................................17
18. Spouse Tax Adjustment (STA). Filing Status 2
only. Enter Spouse’s VAGI in box here
and STA amount on Line 18. 18
19. Net Amount of Tax - Subtract Line 18 from Line 17 .......................................................................19
20. Virginia income tax withheld for 2015. Enclose copies of Forms W-2, W-2G, 1099 and/or VK-1.
20a. Your Virginia withholding ..........................................................................................................20a
20b. Spouse’s Virginia withholding (Filing Status 2 only) .................................................................20b
21. Estimated tax payments for taxable year 2015 (from Form 760ES) ....................................................21
22. Amount of 2014 overpayment applied toward 2015 estimated tax ......................................................22
23. Extension Payments (from Form 760IP) .............................................................................................23
24.
Tax Credit for Low-Income Individuals or Earned Income Credit from Sch. ADJ, Line 17
.........................24
25. Credit for Tax Paid to Another State from Schedule OSC, Line 21.
You must enclose Schedule OSC and a copy of all other state returns. .............................................25
26. Credit for Political Contributions ..........................................................................................................26
27. Credits from enclosed Schedule CR, Section 5, Part 1, Line 1A ....................................................27
28. Add Lines 20a through 27 .................................................................................................................28
29. If Line 28 is less than Line 19, subtract Line 28 from Line 19. This is the Tax You Owe ....................29
30. If Line 19 is less than Line 28, subtract Line 19 from Line 28. This is Your Tax Overpayment ...........30
31. Amount of overpayment you want credited to next year’s estimated tax ............................................31
32. Virginia College Savings Plan Contributions from Schedule VAC, Section I, Line 6 ..........................32
33. Other Voluntary Contributions from Schedule VAC, Section II, Line 14 ..............................................33
34. Addition to Tax, Penalty and Interest from enclosed Schedule ADJ, Line 21. .....................................34
35. Consumer’s Use Tax. You may be liable if sales tax was not paid on Internet or other
purchases. See instructions.. ..............................................................................................................35
36. Add Lines 31 through 35 ...................................................................................................................36
37. If you owe tax on Line 29, add Lines 29 and 36. OR If Line 30 is less than Line 36, subtract Line 30
from Line 36. Enclose payment or pay at www.tax.virginia.gov. ......... AMOUNT YOU OWE ......37
fill in oval if paying by credit or debit card - see instructions
38. If Line 30 is greater than Line 36, subtract Line 36 from Line 30. ............ YOUR REFUND ..............38
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Preparer’s PTIN
Firm Name
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.
Preparer’s Name
Filing Election
Phone Number
Your
Phone
Spouse‘s
Phone
I (We) authorize the Dept. of Taxation to discuss this return with my (our) preparer.
I agree to obtain my Form 1099-G at www.tax.virginia.gov.
Office
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