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(It is recommended that you include your Social Security
(See Instruction 23 ) Total
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1 Wages salaries tips etc
10 Rents royalties partnerships estates trusts etc (Circle appropriate item )
11 Farm income or (loss)
110 Carroll Street Annapolis Maryland 21411 0001
12 Unemployment compensation (insurance)
13 Taxable amount of Social Security and Tier 1 Railroad Retirement benefits
14 Other income (including lottery or other gambling winnings)
15 Total income (Add lines 1 through 14 )
16 Total adjustments to income from federal return (IRA alimony etc )
17 Adjusted gross income (Subtract line 16 from line 15 )
2 Taxable interest income
2014 NAME SSN
26 Deduction amount (Multiply lines 26a or 26d by the AGI factor ) 26e (from worksheet in Instruction 14 )
27 Net income (Subtract line 26 from line 25 )
28 Total exemption amount (from EXEMPTIONS area page 1) See Instruction 10
29 Enter your AGI factor (from worksheet in Instruction 14)
3 Dividend income
30 Maryland exemption allowance (Multiply line 28 by line 29 )
31 Taxable net income (Subtract line 30 from line 27 ) Figure tax on Form 505NR
32 a Maryland tax from line 16 of Form 505NR (Attach Form 505NR )
32 b Special nonresident tax from line 17 of Form 505NR (Attach Form 505NR )
32 c Total Maryland tax (Add lines 32a and 32b )
33 Earned income credit from worksheet in Instruction 20
34 Poverty level credit from worksheet in Instruction 20
35 Other income tax credits for individuals from Part H line 8 of Form 502CR (Attach Form 502CR )
36 Business tax credits You must file this form electronically to claim business tax credits on Form 500CR
37 Total credits (Add lines 33 through 36 )
38 Maryland tax after credits (Subtract line 37 from line 32c ) If less than 0 enter 0
39 Contribution to Chesapeake Bay and Endangered Species Fund (See Instruction 21 )
4 Taxable refunds credits or offsets of state and local income taxes
40 Contribution to Developmental Disabilities Services and Support Fund (See Instruction 21 )
41 Contribution to Maryland Cancer Fund (See Instruction 21 )
42 Total Maryland income tax and contributions (Add lines 38 through 41 )
43 Total Maryland tax withheld (Enter total from and attach your W 2 and 1099 forms if MD tax is withheld )
44 2014 estimated tax payments amount applied from 2013 return payments made with Form 502E and Form MW506NRS
45 Refundable earned income credit from worksheet in Instruction 22
46 Nonresident tax paid by pass through entities (Attach Maryland Form 510 Schedule K 1 )
47 Refundable income tax credits from Part I line 6 of Form 502CR (Attach Form 502CR See Instruction 22 )
48 Total payments and credits (Add lines 43 through 47 )
49 Balance due (If line 42 is more than line 48 subtract line 48 from line 42 )
5 Alimony received
50 Overpayment (If line 42 is less than line 48 subtract line 42 from line 48 )
51 Amount of overpayment TO BE APPLIED TO 2015 ESTIMATED TAX
52 Amount of overpayment TO BE REFUNDED TO YOU (Subtract line 51 from line 50 ) See line 55
53 Interest charges from Form 502UP
54 TOTAL AMOUNT DUE (Add line 49 and line 53 ) IF $1 OR MORE PAY IN FULL WITH THIS RETURN
55 For the direct deposit option complete the following information clearly and legibly:
55a Type of account:
55b Routing number 55c Account
588 To comply with banking rules check here
6 Business income or (loss)
65 or over 65 or over
7 Capital gain or (loss)
8 Other gains or (losses) (from federal Form 4797)
9 Taxable amount of pensions IRA distributions and annuities
a person other than taxpayer the declaration is based on all information of which the preparer has any knowledge
A Yourself Spouse A Enter No Checked
Address and telephone number of preparer
attach the Dependents' Information Form 502B to this form in order to receive the applicable exemption amount
B Enter No Checked
Blind Blind
C Enter No from line 3 of Dependent Form 502B
Check here
Checking
CODE NUMBERS (3 digits per box)
COM/RAD 022
Comptroller of Maryland Revenue Administration Division
D Enter Total Exemptions (Add A B and C )
Daytime telephone no Home telephone no
DIRECT DEPOSIT OF REFUND (See Instruction 23 ) Be sure the account information is correct For Splitting Direct Deposit see Form
Dollars Cents
EXEMPTIONS See Instruction 10 Check appropriate box(es) NOTE: If you are claiming dependents you must
if this refund will go to an account outside the United States If checked see Instruction 23
if you agree to receive your 1099G Income Tax Refund state
if you authorize your
if you authorize your preparer to discuss this return with us Check here
INCOME AND ADJUSTMENTS INFORMATION (See Instruction 11 )
Make checks payable and mail to:
MARYLAND
MARYLAND TAX COMPUTATION COMPLETE FORM 505NR BEFORE CONTINUING
ment electronically Under penalties of perjury I declare that I have examined this return including accompanying
Net itemized deductions (Subtract line 26c from line 26b )
NONRESIDENT INCOME
number
Number on check using blue or black ink )
or for late filing
PAGE 2
paid preparer not to file electronically Check here
Preparer s PTIN (required by law) Signature of preparer other than taxpayer
REFUND
Savings
schedules and statements and to the best of my knowledge and belief it is true correct and complete If prepared by
See Instruction 10 A $
See Instruction 10 C $
Spouse s signature Date
State and local income taxes (See Instruction 16 )
TAX RETURN
Total federal itemized deductions (from line 29 federal Schedule A)
X $1 000 B $
Your signature Date