Form 502-502B Fillable Maryland Resident Income Tax Return with Form 502B
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

if you agree to receive your 1099G Income Tax Refund statement electronically Under penalties of perjury I declare that I have examined Total Amount D $ (: 1) Unchecked (: 2) Unchecked (: 3) Unchecked (: 4) Unchecked (: 5) Unchecked (: 6) Unchecked (: C) Unchecked (: I) Unchecked (: N) Unchecked (: N) Unchecked (: N) Unchecked (: S) Unchecked (: Y) Unchecked (: Y) Unchecked (: Y) Unchecked (9 digits) (All taxpayers must select one method and check the appropriate box ) (Attach to Form 502 505 or 515 ) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (For Form 502 resident taxpayers only ) (For Form 502 resident taxpayers only ) (For Form 502 resident taxpayers only ) (See Instruction (See Instruction 12 (See Instruction 13 (See Instruction 22 ) Total (See Instruction 26 ) (Subtract line 46 from line 45 ) See line 50 REFUND (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) (text) (text) (text) (text) 1 Adjusted gross income from your federal return (See Instruction 11 ) 1 Enter the total number of boxes checked below for Regular dependents (6) 1 1 First name 1 First name 1 First name 110 Carroll Street Annapolis Maryland 21411 0001 13 Subtractions from attached Form 502SU (See Instruction 13 ) 14 Two income subtraction from worksheet in Instruction 13 15 Total subtractions from Maryland income (Add lines 8 through 14 ) 16 Maryland adjusted gross income (Subtract line 15 from line 7 ) 17 Deduction amount (Part year residents see Instruction 26 (l and m) ) 17a Total federal itemized deductions (from line 29 federal Schedule A) 17b State and local income taxes (See Instruction 14 ) 18 Net income (Subtract line 17 from line 16 ) 19 Exemption amount from Exemptions area above (See Instruction 10 ) 1a Wages salaries and/or tips (See Instruction 11 ) 1b Earned income (See Instruction 11 ) 2 Enter the total number of additional boxes checked below for dependents 65 or over (7) 2 2 Social Security Number 2 Social Security Number 2 Social Security Number 2 Tax exempt interest on state and local obligations (bonds) other than Maryland 20 Taxable net income (Subtract line 19 from line 18 ) 2013 ENDING 21 Amount from line 20 (taxable net income) GO TO TAX TABLE in the Resident instructions Enter the tax on line 22 22 Maryland tax (from Tax Table or Computation Worksheet Schedules I or II) 22 23 Earned income credit ( of federal earned income credit See Instruction 18 ) 24 Poverty level credit (See Instruction 18 ) 25 Other income tax credits for individuals from Part H line 8 of Form 502CR (Attach Form 502CR ) 25 26 Business tax credits You must file this form electronically to claim business tax credits on Form 500CR 27 Total credits (Add lines 23 through 26 ) 27 28 Maryland tax after credits (Subtract line 27 from line 22 ) If less than 0 enter 0 28 3 Relationship 3 Relationship 3 Relationship 3 State retirement pickup 3 Total dependent exemptions (Add lines 1 and 2 and enter the total here and on line (C) of the 30 Local earned income credit (from Local Earned Income Credit Worksheet in Instruction 19 ) 31 Local poverty level credit (from Local Poverty Level Credit Worksheet in Instruction 19 ) 32 Total credits (Add lines 30 and 31 ) 33 Local tax after credits (Subtract line 32 from line 29 ) If less than 0 enter 0 34 Total Maryland and local tax (Add lines 28 and 33 ) 35 Contribution to Chesapeake Bay and Endangered Species Fund (See Instruction 20 ) 36 Contribution to Developmental Disabilities Waiting List Equity Fund (See Instruction 20 ) 37 Contribution to Maryland Cancer Fund (See Instruction 20 ) 38 Total Maryland income tax local income tax and contributions (Add lines 34 through 37 ) 39 Total Maryland and local tax withheld (Enter total from your W 2 and 1099 forms if MD tax is 4 Lump sum distributions (from worksheet in Instruction 12 ) 40 2013 estimated tax payments amount applied from 2012 return payment made 41 Refundable earned income credit (from worksheet in Instruction 21) 42 Refundable income tax credits from Part I line 6 of Form 502CR (Attach Form 502CR See Instruction 21 ) 43 Total payments and credits (Add lines 39 through 42 ) 43 44 Balance due (If line 38 is more than line 43 subtract line 43 from line 38 ) 45 Overpayment (If line 38 is less than line 43 subtract line 38 from line 43 ) 46 Amount of overpayment TO BE APPLIED TO 2014 ESTIMATED TAX 48 Interest charges from Form 502UP 49 TOTAL AMOUNT DUE (Add lines 44 and 48 ) IF $1 OR MORE PAY IN FULL WITH THIS RETURN 5 Has medical insurance? Yes No 5 Has medical insurance? Yes No 5 Has medical insurance? Yes No 5 Other additions (Enter code letter(s) from Instruction 12 ) 50b Routing Number 50c Account 6 Regular 6 Regular 6 Regular 6 Total additions to Maryland income (Add lines 2 through 5 ) 65 or over 65 or over 65 or over 65 or over 7 Total federal adjusted gross income and Maryland additions (Add lines 1 and 6 ) 8 Taxable refunds credits or offsets of state and local income taxes included in line 1 above 9 Child and dependent care expenses ADDITIONS Address of preparer Amount of overpayment TO BE REFUNDED TO YOU Attachment B Enter No Checked Blind by your local tax rate or use the Local Tax Worksheet C Enter No from line 3 of Dependent Form 502B CHECK Check here Check here if you authorize us to share your tax information with the Medical Assistance Program CHECK ONE BOX Checking City or Town City Town or Taxing Area CODE NUMBERS (3 digits per box) COM/RAD 009 13 49 COM/RAD 026 13 49 Comptroller of Maryland Revenue Administration Division Dates of Maryland Residence day of the taxable period (See Instruction 6 ) Daytime telephone no Home telephone no DEDUCTION METHOD Dependent taxpayer (Enter 0 in Exemption Box (A) See Instruction 7 ) Dependents (If a dependent listed below is age 65 or over please check both boxes 6 and 7 ) Dependents' Information Form 502B to this form to receive the applicable exemption amount DIRECT DEPOSIT OF REFUND (See Instruction 22 ) Please be sure the account information is correct For Splitting Direct Deposit see Form 588 Enter amount here: Enter Total Exemptions (Add A B and C ) Exemptions area of Form 502 505 or 515 ) 3 EXEMPTIONS See Instruction 10 Check appropriate box(es) NOTE: If you are claiming dependents you must attach the FILING STATUS 1 for help finding health insurance For the direct deposit option complete the following information clearly and legibly 50a Type of account: FROM INCOME Head of household if this refund will go to an account outside the United States If checked see Instruction 22 if under 19 if under 19 if under 19 if you are required to file if you authorize your paid preparer not to file electronically if you authorize your preparer to discuss this return with us Check here If you began or ended legal in this box included in line 1 above INCOME Income received during period of nonresidence (See Instruction 26 ) Initial Initial Initial Initial Initial Ink Only ITEMIZED DEDUCTION METHOD (Complete lines 17a and 17b ) Last name Last name Last name Last name Last Name Local tax (See Instruction 19 for tax rates and worksheet ) Multiply line 21 LOCAL TAX COMPUTATION Make checks payable and mail to: Mar yland County Married filing joint return or spouse had no income Married filing separately MARYLAND Dependents' Information Maryland military income place an M in the box MARYLAND RESIDENT INCOME MARYLAND TAX COMPUTATION MILITARY: If you or your spouse has non MO DAY YEAR Name of county and incorporated city town or NAME SSN No 02 No 06 number on top of your W 2 wage and tax or Black OR FISCAL YEAR BEGINNING or for late filing or MONEY ORDER Other state of residence: Page 2 PART YEAR RESIDENT Pension exclusion from worksheet in Instruction 13 person other than taxpayer the declaration is based on all information of which the preparer has any knowledge Place place a P in the box Place an M or P Preparer s PTIN (required by law) Signature of preparer other than taxpayer Present Address (No and street) Print Using Print UsingBlue or Black Ink Qualifying widow(er) with dependent child residence in Maryland in 2013 Savings See Instruction 1 to determine 2 See Instruction 10 A $ See Instruction 10 C $ See Instruction 26 Sequence Single (If you can be claimed on another person s tax return use Filing Status 6 ) 4 Social Security Number Social Security Number on check ) special taxing area in which you resided on the last Spouse A Enter No Checked Spouse s first name Spouse s signature Spouse's First Name Spouse's Social Security Number Spouse's Social Security Number STANDARD DEDUCTION METHOD (Enter amount on line 17 ) staple State statements and ATTACH HERE with Subtract line 17b from line 17a and enter amount on line 17 SUBTRACTIONS Summary TAX RETURN Taxable Social Security and RR benefits (Tier I II and supplemental) Telephone number of preparer this return including accompanying schedules and statements and to the best of my knowledge and belief it is true correct and complete If prepared by a (It is recommended that you include your To comply with banking rules please check here TO INCOME with an extension request and Form MW506NRS withheld and attach ) X $1 000 B $ Your first name Your signature Yourself ZIP code