Form 200-02X Fillable Non-Resident Amended Income Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

X 0000 (: Yes) Unchecked (: Yes) Unchecked (: Yes) Unchecked (: Yes) Unchecked (: Yes) Unchecked (a) If you elect the STANDARD DEDUCTION check here (b) If you elect to ITEMIZE DEDUCTIONS check here (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (Print Form) Print Form (Reset the Form) Reset (Rev 10/24/13) Toll free telephone number (Delaware only) 1 800 292 7826 (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) ) and enter total here *DF21213019999* *DF21213029999* 00 = Proration Rate Table/Schedule 11 BALANCE (Subtract Line 10 from Line 6 cannot be less than ZERO) 12 Delaware Tax Withheld (W 2's and or 1099's Required) 12 13 Estimated Tax Paid & Payments with Extensions 13 14 S Corp Payments and Refundable Business Credits 14 15 2013 Capital Gains Tax Payments 15 16 Amount paid (if any see instructions) 16 17 TOTAL Refundable Credits (Add Lines 12 13 14 15 & 16) 18 Refund received (if any see instructions) 19 Estimated Tax Carryover and/or Special Funds Contribution as shown on original return 2 Joint or Entered 20 Subtract Lines 18 and 19 from Line 17 21 BALANCE DUE If Line 11 ismore than Line 20 subtract 20from 11 and enter here 22 OVERPAYMENT If Line 20 is more than Line 11 subtract 11 from 20 and enter here > 23 AMOUNT OF LINE 22 TO BE APPLIED TO YOUR ESTIMATED TAX ACCOUNT (See Instructions) ENTER > 24 PENALTIES AND INTEREST DUE ENTER > 25 NET BALANCE DUE Enter the amount due (Line 21 plus Lines 23 and 24) and pay in full PAY IN FULL > 26 NET REFUND Subtract Lines 23 and 24 from Line 22 TO BE REFUNDED/ ZERO DUE > 27 Wages salaries tips etc 28 Interest 29 Dividends 31 Alimony received 32 Business income or (loss) (See instructions) 33a Capital gain or (loss) 33b Other gains or (losses) 34 IRA distributions 35 Taxable pensions and annuities 36 Rents royalties partnerships S corps estates trusts etc 37 Farm income or (loss) 38 Unemployment compensation (insurance) 40 Other income (state nature and source) 41 Total income Add Lines 27 through 40 42 Total Federal Adjustments (See instructions) 43 Federal Adjusted Gross Income for Delaware purposes Subtract Line 42 from 41 44 Interest received on obligations of any state other than Delaware 45 Fiduciary adjustment oil depletion 46 TOTAL Add Lines 44 & 45 47 Add Lines 43 & 46 48 Interest received on U S Obligations 49 Pension/Retirement Exclusions (See instructions) 5 Head of 50 Delaware State t ax refund 51 Fiduciary Adjustment Work Oppor tunity Credit Delaware NOL Carryforward 53 TOTAL Add Lines 48 through 52 54 Subtract Line 53 from Line 47 and enter here 55 Exclusion for certain persons 60 and over or disabled (See instructions) 56A Column 2 56B Column 1 Subtract Line 55 from Line 54 This is your Delaware Adjusted Gross Income 57 Enter total Itemized Deductions (If Filing Status 3 see instructions) 58 Enter Foreign Taxes Paid (See instructions) 59 Enter Charitable Mileage Deduction (See instructions) 60 TOTAL Add Lines 57 58 and 59 60 61a Enter State Income Tax included in Line 57 above (See Instructions) 61a 61b Enter Form 700 Tax Credit Adjustment (See instructions) 61b 62 Subtract Line 61a and 61b from Line 60 Enter here and on front Line 2 7b CHECK BOX(ES) Spouse 60 or Over (if Filing status 2) A DETAILED EXPLANATION OF ALL CHANGES MUST BE PROVIDED IN THIS SPACE ALL SUPPORTING SCHEDULES AND/OR DOCUMENTATION MUST BE ATTACHED A Modified Delaware Sourced Income ADDITIONAL STANDARD DEDUCTIONS (Not allowed with Itemized Deductions see instructions) and/or Blind ATTACH LABEL B Delaware Adjusted Gross Income CHECK BOX(ES) Check if FULL YEAR City State Zip Code COLUMN 1 COLUMN 1 COLUMN 2 COLUMN 2 SECTION A INCOME AND ADJUSTMENTS FROM FEDERAL RETURN COMPLETE ALL SECTIONS OF THIS RETURN NAMES AND SSN S MUST MATCH ORIGINAL RETURN CORRECTED AMOUNTS DE Source Income/Loss DELAWARE DELAWARE ADJUSTED GROSS INCOME DO NOT WRITE OR STAPLE IN THIS AREA Enter number of boxes checked on Line 7b X $110 = Enter on front side Line 1 and Line 6 Box B Enter on front side Line 6 Box A Federal FILING STATUS (MUST CHECK ONE) Filing Statuses 1 3 & 5 $3250 Filing Status 2 $6500 FORM 200 02 X FORM 200 02 X 2013 Page 2 From 20132013 To HAS THE DELAWARE DIVISION OF REVENUE ADVISED YOU YOUR ORIGINAL RETURN IS BEING AUDITED? Household IF NO PLEASE EXPLAIN IF THE CHANGES PERTAIN TO THE DE RETURN ONLY LIST THE LINE NUMBERS BEING AMENDED If SPOUSE was 65 or over If YOU were 65 or over If you were a part year resident in 2013 give the dates you resided inDelaware into a Civil Union IS AN AMENDED FEDERAL RETURN BEING FILED? IS THIS AMENDED RETURN BEING FILED AS A PROTECTIVE CLAIM? YES NO Married or Entered into a Civil Month Day Multiply this amount by the proration decimal on Line 6 (X NET REFUND / ZERO DUE (LINE 26): P O BOX 8772 WILMINGTON DE 19899 8772 NON RESIDENT AMENDED non resident in 2013 Form DE2210 Attached NOTE: IF YOUR ORIGINAL RETURN WAS FILED USING TWO SEPARATE FORMS YOU MUST FILE TWO SEPARATE AMENDED FORMS or Fiscal year beginning and ending Other Non Refundable Credits 9 Personal Credits (See Instructions) Enter number of exemptions claimed on Federal return X $110 = PERSONAL INCOME TAX RETURN Present Home Address (Number and Street) Apt # REMIT FORM TO: NET BALANCE DUE (LINE 25): P O BOX 8752 WILMINGTON DE 19899 8752 s of state & local income taxes SECTION B DELAWARE MODIFICATIONS AND ADJUSTMENTS ADDITIONS ( + ) SECTION C DELAWARE MODIFICATIONS AND ADJUSTMENTS SUBTRACTIONS ( ) SECTION D ITEMIZED DEDUCTIONS (ATTACH FEDERAL SCHEDULE A FORM 1040) Self 60 or Over SIGNATURE OF PREPARER PREPARER S EIN OR SSN PREPARER S PHONE DATE Single Divorced Spouse s Last Name Spouse s First Name Jr Sr III etc STAPLE CHECK HERE STAPLE W 2 FORMS HERE STREET ADDRESS OF PREPARER CITY STATE ZIP Tax imposed by State of (Part Year Residents only) 8 Tax Liability Computation Tax Liability from Tax TAXABLE INCOME Subtract Line 4 from Line 1 and compute tax on this amount TOTAL DEDUCTIONS ADD LINES 2 and 3 and enter here Total Non Refundable Credits (Add Lines 7a 7b 8 and 9) 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 Union & Filing Separate Forms Widow(er) YES NO Your Last Name First Name and Middle Initial Jr Sr III etc YOUR SIGNATURE DATE TELEPHONE NUMBER SPOUSE SIGNATURE (If Filing Joint) Your Social Security No Spouse s Social Security No