Datasets:

Gagan271

/

Test-llama2-1k

like 0

Yes, you can claim itemized deductions on the Virginia Resident Form 760 Individual Income Tax Return. To report them, you need to fill out the Virginia Schedule A and report expenses for which payment was made while you were a Virginia resident. State and local income tax claimed as an itemized deduction on your federal return is not allowed as a Virginia deduction. If you have an addition or subtraction due to Fixed Date Conformity, you must complete the FDC Worksheet to compute your Virginia itemized deductions. The total itemized deductions claimed on federal Schedule A or the FDC Worksheet if you have an addition or subtraction due to Fixed Date Conformity paid while a resident of Virginia should be entered on Line 47a, and the amount of state and local income tax allowed on your federal Schedule A that was paid while you were a resident of Virginia should be entered on Line 47b.

Can you claim itemized deductions on the Virginia Resident Form 760 Individual Income Tax Return? If so, how do you report them?

2019 Virginia Resident Form 760 Individual Income Tax Return File by May 1 2020 PLEASE USE BLACK INK 1 Not federal taxable income 1 2 Additions from Schedule ADJ Line 3 2 3 3 4 Age Deduction See Instructions Be sure to provide date of birth above 4 5 6 7 Subtractions from Schedule ADJ Line 7 7 8 8 9 Subtract Line 8 from Line 3 Enter the result on this line Note 10 Itemized Deductions from Virginia Schedule A See instructions 10 11 If you do not claim itemized deductions on Line 10 enter standard deduction See instructions 11 12 12 13 Deductions from Schedule ADJ Line 9 13 14 14 15 15 2601031 Rev 6 19 Social Security Number Filing Status Enter in box 1 Single 2 Joint and 3 Married Filing Separately M I M I State ZIP Code Federal head of household YES Name or Filing Status changed Virginia return not Dependent on another s return merchant seaman Amended Return Result of NOL YES Overseas on due date Earned Income Credit on federal return Amount claimed Code First 4 letters of last name LOSS 00 00 LOSS 00 00 00 00 00 LOSS 00 00 00 00 LOSS 00 LOSS 00 LOSS 00 Locality Code 00 Exemptions Add Sections A and B Enter the sum on Line 12 X 800 Spouse 65 or over You 65 or over Spouse Blind You Blind X 930 1 Total Section A Spouse if Filing Status 2You Dependents 00 00 You You Spouse If Filing Status 3 enter spouse s SSN in the Spouse s Social Security Number enter Spouse s Name You Spouse Total Section B VA Driver s License Information Issue DateCustomer ID You Spouse Deceased Your SSN Domestic Accounts Only No International Deposits Bank Routing Transit Number Checking SavingsBank Account Number 16 only Enter Spouse s STA amount on Line 17 17 18 18 19a Your Virginia withholding 20 21 22 23 23 You must enclose Schedule OSC and a copy of all other state returns 24 25 Credits from 25 26 26 27 28 30 Virginia529 and ABLEnow Contributions from Schedule VAC Section I Line 6 30 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 32 See instructions FILL IN OVAL IF NO SALES AND USE TAX IS DUE 33 34 34 If Line 28 is less than Line 34 subtract Line 28 from Line 34 Enclose payment or pay at 35 FILL IN OVAL IF PAYING BY CREDIT OR DEBIT CARD SEE INSTRUCTIONS 36 If Line 28 is greater than Line 34 subtract Line 34 from Line 28 36 If the Direct Deposit section below is not completed your refund will be issued by check Preparer s PTINFirm 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 ElectionPhone Number Your Phone Spouse s Phone www tax virginia gov ID Theft PIN 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 LOSS 00

No, you cannot claim itemized deductions on Line 11 of Form 760PY if you do not have any itemized deductions.

Can you claim itemized deductions on Line 11 of Form 760PY if you do not have any itemized deductions?

2019 Virginia Part Year Resident Income Tax Return Due May 1 2020 Form 760PY Page 1 Your Birth Date mm dd yyyy Spouse s Birth Date mm dd yyyy B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 00 00 1 FEDERAL ADJUSTED GROSS INCOME from Schedule of Income Part 1 Line 7 Column 1 1 2 Additions from Schedule 760PY ADJ Line 3 2 00 00 3 3 00 00 4 Qualifying Age Deduction Enter Birth Dates above Complete Age Deduction Worksheet in instructions Enter Spouse s Age Deduction on Line 4b Column B when using Filing Status 4 ONLY Otherwise claim Your Age Deduction on Line 4a Column A and Spouse s on Line 4b Column A 4a 00 4b 00 00 5 reported as taxable income on federal return and attributable to your period of residence in Virginia 5 00 00 6 State income tax refund or overpayment credit reported as income on your federal return and received while a Virginia resident Claim in the same column you reported adjusted gross income on Line 1 6 00 00 7 Income attributable to your period of residence outside Virginia from Schedule of Income Part 1 Line 9 Column 3 7 00 00 8 Subtractions from Schedule 760PY ADJ Line 7 8 00 00 9 9 00 00 10 10 00 00 11 Itemized Deductions from Virginia Schedule A See Instructions 11 00 00 12 If you do not claim itemized deductions on Line 11 enter standard deduction from Standard Deductions Worksheet in instructions 12 00 00 For Local Use DATE OF BIRTH LTD Va Dept of Taxation 2601039 Rev 8 19 Filing Status Enter Filing Status Code in box below 1 Single Column A Federal head of household YES 2 Married Filing Joint return Column A Married Filing Separate returns Column A 4 Married Filing Separately on this combined return Columns A and B 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 Exemptions Enter the number of exemptions being claimed You Spouse Dependents 65 or Over Blind A You Enter the numbers for both You and Spouse if Filing Status 2 B Spouse Filing Status 4 Only Check Boxes Amended Return Check if Result of NOL Qualifying Farmer Fisherman or Merchant Seaman Combined Social Security for You and Spouse reported as taxable income on Federal Return Dependent on Another s Return Earned Income Credit Claimed on federal return Overseas on Due Date Enclose a complete copy of your federal tax return and all other required Virginia enclosures Dates of VA Residence mm dd yyyy YOUR First Name MI Your Last Name Check if deceased A Your Social Security Number You From You To SPOUSE S MI Spouse s Last Name Check if deceased B Spouse s Social Security Number Spouse From Spouse To Present Home Address Number and Street or Rural Route VA Driver s License Information Customer ID You Spouse Issue Date mm dd yyyy You Spouse State ZIP Code Locality Code B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 13 Prorated exemption amount from Schedule of Income Part 2 Line 11 See instructions 13 00 00 14 Deductions from Schedule 760PY ADJ Line 9 14 00 00 15 15 00 00 16 16 00 00 17 Tax amount from Tax Table or Tax Rate Schedule 17 00 00 18 18 00 19a Your Virginia income tax withheld Enclose copies of Forms W 2 W 2G 1099 and VK 1 19a 00 19b Spouse s Virginia income tax withheld Enclose copies of Forms W 2 W 2G 1099 and VK 1 19b 00 20 Combined 2019 Estimated Tax Payments 20 00 21 2018 overpayment credited to 2019 estimated taxes 21 00 22 Extension Payment Enter amount paid on Form 760IP 22 00 23 Tax Credit for Low Income Individuals or Virginia Earned Income Credit from Schedule 760PY ADJ Line 17 23 00 24 Total credit for taxes paid to another state from Schedule OSC 24 00 25 Credits from Schedule CR Section 5 Line 1A 25 00 26 26 00 27 27 00 28 28 00 29 Amount of overpayment on Line 28 to be CREDITED TO 2020 ESTIMATED INCOME TAX 29 00 30 Virginia529 and ABLEnow Contributions from Schedule VAC Section I Line 6 30 00 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 00 32 Addition to Tax Penalty and Interest from enclosed Schedule 760PY ADJ Line 21 32 00 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions Check here if no sales and use tax is due 33 00 34 34 00 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is an overpayment and Line 34 is larger than AMOUNT YOU OWE Check here if paying by credit or debit card See instructions 35 00 36 If Line 28 is larger than Line 34 subtract Line 34 from Line 28 36 00 2019 Form 760PY Page 2 Your Name Your SSN I We authorize the Department of Taxation to discuss this return with my our preparer I agree to obtain my Form 1099 G at www tax virginia gov Your Bank Routing Transit Number Your Bank Account Number Checking Savings If the Direct Deposit section below is not completed your refund will be issued by check DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits 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 Your Signature Your Phone Number Date Spouse s Signature If a joint return must sign Spouse s Phone Number Date Preparer s Name Preparer s Phone Number Date Firm s Name or Yours if Self Employed Preparer s PTIN Vendor Code Filing Election Code ID Theft PIN

The specific amount for the adjusted gross income (AGI) cannot be determined as it is dependent on the individual's personal tax return. The instructions only provide guidance on how to enter the AGI on the Virginia income tax return.

How much is the adjusted gross income (AGI)?

VA0760121888 2021 Virginia Form 760 Resident Income Tax Return File by May 1 2022 USE BLACK INK2601031 Rev 07 21 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 State ZIP Code 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 Virginia Schedule A See instructions 10 11 If you do not claim itemized deductions on Line 10 enter standard deduction See instructions 11 12 Exemptions Sum of total from Exemption Section A plus Exemption Section B 12 13 Deductions from Schedule ADJ Line 9 13 14 Add Lines 10 11 12 and 13 14 15 Virginia Taxable Income Subtract Line 14 from Line 9 15 loss 00 00 loss 00 00 00 00 00 loss 00 00 00 00 loss 00 loss 00 loss 00 00 Exemptions Add Sections A and B Enter the sum on Line 12 X 930 1 Total Section A Spouse if Filing Status 2You Dependents 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 Reason Code Overseas on due date Federal Schedule C filed Earned Income Credit on federal return Amount claimed Spouse 00 00 You Social Security Number First 4 letters of last name You Spouse Filing Status Enter in box 1 Single 2 Joint and 3 Married Filing Separately Federal head of household Filing Status 1 only YESCode 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 X 800 Spouse 65 or over You 65 or over Spouse Blind You Blind Total Section B Issue DateVA Driver s License Information Customer ID You Spouse Birth Date mm dd yyyy Locality CodeYou Spouse Deceased LTD LAR DLAR DTD I we are uninsured and authorize the sharing of certain information from Form 760 and Schedule ADJ as described in the instructions with the Department of Medical Assistance Services DMAS for purposes of identifying persons who would like to newly enroll in medical assistance WEB VA0760221888 Page 2 2021 Form 760 Your SSN DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits Bank Routing Transit Number Checking SavingsBank Account Number 16 Amount of Tax from Tax Table or Tax Rate Schedule round to whole dollars 16 17 Spouse Tax Adjustment STA Filing Status 2 only Enter Spouse s VAGI in box here and STA amount on Line 17 17 18 Net Amount of Tax Subtract Line 17 from Line 16 18 19 Virginia income tax withheld for 2021 Enclose copies of Forms W 2 W 2G 1099 and or VK 1 19a Your Virginia withholding 19a 19b Spouse s Virginia withholding Filing Status 2 only 19b 20 Estimated tax payments for taxable year 2021 from Form 760ES 20 21 Amount of 2020 overpayment applied toward 2021 estimated tax 21 22 Extension Payments from Form 760IP 22 23 Tax Credit for Low Income Individuals or Earned Income Credit from Sch ADJ Line 17 23 24 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 24 25 Credits from enclosed Schedule CR Section 5 Part 1 Line 1A 25 26 Add Lines 19a through 25 26 27 If Line 26 is less than Line 18 subtract Line 26 from Line 18 This is the Tax You Owe 27 28 If Line 18 is less than Line 26 subtract Line 18 from Line 26 This is Your Tax Overpayment 28 29 Amount of overpayment you want credited to next year s estimated tax 29 30 Virginia529 and ABLE Contributions from Schedule VAC Section I Line 6 30 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 32 Addition to Tax Penalty and Interest from enclosed Schedule ADJ Line 21 32 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions fill in oval if no sales and use tax is due 33 34 Add Lines 29 through 33 34 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is less than Line 34 subtract Line 28 from Line 34 Enclose payment or pay at www tax virginia gov AMOUNT YOU OWE 35 fill in oval if paying by credit or debit card see instructions 36 If Line 28 is greater than Line 34 subtract Line 34 from Line 28 YOUR REFUND 36 If the Direct Deposit section below is not completed your refund will be issued by check e Preparer s PTINFirm 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 ElectionPhone 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 ID Theft PIN 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 loss 00 WEB

The purpose of Line 2 on Form 763 ADJ is to report other additions, including those related to Fixed Date Conformity, that should be added to federal adjusted gross income. It also requires the total of Lines A and B to be entered on Schedule 763 ADJ.

What is the purpose of Line 2 on Form 763 ADJ?

Avoid delays If completed submit Schedule 763 ADJ with Form 763 2015 Virginia Schedule 763 ADJ Form 763 ADJ Page 1 VA3ADJ115888 Your Name Your SSN VA Dept of Taxation 2601045 763ADJ REV 08 15 Additions to Adjusted Gross Income 1 Interest on obligations of other states exempt from federal income tax but not from state tax 1 00 2 Other additions to adjusted gross income 002a Fixed Date Conformity addition See instructions 2a 2b 2c Refer to the Form 763 instructions for Other Addition Codes 2b 2b 00 2c 2c 00 3 Total Additions Add Lines 1 2a 2c Enter here and on Form 763 Line 2 3 00 Subtractions from Adjusted Gross Income 4 Income interest dividends or gains from obligations or securities of the U S exempt from state income tax but not from federal tax 4 00 5 Disability income reported as wages or payments in lieu of wages on your federal return If claiming this subtraction you cannot also claim Age Deduction Claim the one that benefits you most 5a Enter YOUR disability subtraction on 5a 5a 00 5b Enter SPOUSE s disability subtraction on 5b if claiming Filing status 2 5b 00 6 Other Subtractions as provided in instructions 6a Fixed Date Conformity subtraction See instructions 6a 00 6b 6d Refer to the Form 763 instructions for Other Subtraction Codes 6b 6b 00 6c 6c 00 6d 6d 00 7 Total Subtractions Add Lines 4 5a 5b and 6a 6d Enter here and on Form 763 Line 7 7 00 Deductions from Virginia Adjusted Gross Income 8 Refer to the Form 763 instructions for Deduction Codes 8a 8a 00 8b 8b 00 8c 8c 00 9 Total Deductions Add Lines 8a 8c Enter here and on Form 763 Line 14 9 00 VA3ADJ21588 2015 Virginia Schedule 763 ADJ Page 2 Your Name Your SSN Tax Credit for Low Income Individuals or Virginia Earned Income Credit SEE INSTRUCTIONS Family VAGI Name Social Security Number SSN Guideline Income Yourself 00 Spouse 00 Dependent 00 Dependent 00 10 If more than 4 exemptions enclose schedule listing the name SSN VAGI Enter total Family Guideline Income here 10 00 11 Enter the total number of exemptions reported in the table above Next go to the Poverty Guidelines Table shown in the Form 763 instruction book for this Line to see if you qualify for this credit 11 12 If you qualify enter the number of personal and dependent exemptions reported on your Form 763 see instructions 12 13 Multiply Line 12 by 300 Enter the result on Line 13 and proceed to Line 14 If you do not qualify for the Tax Credit for Low Income Individuals but claimed an Earned Income Credit on your federal return enter 0 and proceed to Line 14 13 00 14 Enter the amount of Earned Income Credit claimed on your federal return If you did not claim an Earned Income Credit on your federal return enter 0 14 00 15 Multiply Line 14 by 20 20 15 00 16 Enter the greater of Line 13 or Line 15 16 00 17 Compare the amount on Line 16 above to the amount of tax on Form 763 Line 19 Enter the lesser of the two amounts here and on Form 763 Line 24 This is your credit amount 17 00 Addition to Tax Penalty and Interest 18 Addition to tax Check if addition came from Form 760C Form 760F 18 00 19 Penalty Late Filing Penalty Extension Penalty 19 00 20 Interest accrued on the tax you owe 20 00 21 Total Addition to Tax Penalty and Interest add Lines 18 20 Enter here and on Form 763 Line 34 21 00

If using Filing Status 3, you enter your spouse's Social Security Number on the line beside the Filing Status code box.

Where do you enter your Spouse s Social Security Number on Form 760PY?

2019 Virginia Part Year Resident Income Tax Return Due May 1 2020 Form 760PY Page 1 Your Birth Date mm dd yyyy Spouse s Birth Date mm dd yyyy B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 00 00 1 FEDERAL ADJUSTED GROSS INCOME from Schedule of Income Part 1 Line 7 Column 1 1 2 Additions from Schedule 760PY ADJ Line 3 2 00 00 3 3 00 00 4 Qualifying Age Deduction Enter Birth Dates above Complete Age Deduction Worksheet in instructions Enter Spouse s Age Deduction on Line 4b Column B when using Filing Status 4 ONLY Otherwise claim Your Age Deduction on Line 4a Column A and Spouse s on Line 4b Column A 4a 00 4b 00 00 5 reported as taxable income on federal return and attributable to your period of residence in Virginia 5 00 00 6 State income tax refund or overpayment credit reported as income on your federal return and received while a Virginia resident Claim in the same column you reported adjusted gross income on Line 1 6 00 00 7 Income attributable to your period of residence outside Virginia from Schedule of Income Part 1 Line 9 Column 3 7 00 00 8 Subtractions from Schedule 760PY ADJ Line 7 8 00 00 9 9 00 00 10 10 00 00 11 Itemized Deductions from Virginia Schedule A See Instructions 11 00 00 12 If you do not claim itemized deductions on Line 11 enter standard deduction from Standard Deductions Worksheet in instructions 12 00 00 For Local Use DATE OF BIRTH LTD Va Dept of Taxation 2601039 Rev 8 19 Filing Status Enter Filing Status Code in box below 1 Single Column A Federal head of household YES 2 Married Filing Joint return Column A Married Filing Separate returns Column A 4 Married Filing Separately on this combined return Columns A and B 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 Exemptions Enter the number of exemptions being claimed You Spouse Dependents 65 or Over Blind A You Enter the numbers for both You and Spouse if Filing Status 2 B Spouse Filing Status 4 Only Check Boxes Amended Return Check if Result of NOL Qualifying Farmer Fisherman or Merchant Seaman Combined Social Security for You and Spouse reported as taxable income on Federal Return Dependent on Another s Return Earned Income Credit Claimed on federal return Overseas on Due Date Enclose a complete copy of your federal tax return and all other required Virginia enclosures Dates of VA Residence mm dd yyyy YOUR First Name MI Your Last Name Check if deceased A Your Social Security Number You From You To SPOUSE S MI Spouse s Last Name Check if deceased B Spouse s Social Security Number Spouse From Spouse To Present Home Address Number and Street or Rural Route VA Driver s License Information Customer ID You Spouse Issue Date mm dd yyyy You Spouse State ZIP Code Locality Code B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 13 Prorated exemption amount from Schedule of Income Part 2 Line 11 See instructions 13 00 00 14 Deductions from Schedule 760PY ADJ Line 9 14 00 00 15 15 00 00 16 16 00 00 17 Tax amount from Tax Table or Tax Rate Schedule 17 00 00 18 18 00 19a Your Virginia income tax withheld Enclose copies of Forms W 2 W 2G 1099 and VK 1 19a 00 19b Spouse s Virginia income tax withheld Enclose copies of Forms W 2 W 2G 1099 and VK 1 19b 00 20 Combined 2019 Estimated Tax Payments 20 00 21 2018 overpayment credited to 2019 estimated taxes 21 00 22 Extension Payment Enter amount paid on Form 760IP 22 00 23 Tax Credit for Low Income Individuals or Virginia Earned Income Credit from Schedule 760PY ADJ Line 17 23 00 24 Total credit for taxes paid to another state from Schedule OSC 24 00 25 Credits from Schedule CR Section 5 Line 1A 25 00 26 26 00 27 27 00 28 28 00 29 Amount of overpayment on Line 28 to be CREDITED TO 2020 ESTIMATED INCOME TAX 29 00 30 Virginia529 and ABLEnow Contributions from Schedule VAC Section I Line 6 30 00 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 00 32 Addition to Tax Penalty and Interest from enclosed Schedule 760PY ADJ Line 21 32 00 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions Check here if no sales and use tax is due 33 00 34 34 00 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is an overpayment and Line 34 is larger than AMOUNT YOU OWE Check here if paying by credit or debit card See instructions 35 00 36 If Line 28 is larger than Line 34 subtract Line 34 from Line 28 36 00 2019 Form 760PY Page 2 Your Name Your SSN I We authorize the Department of Taxation to discuss this return with my our preparer I agree to obtain my Form 1099 G at www tax virginia gov Your Bank Routing Transit Number Your Bank Account Number Checking Savings If the Direct Deposit section below is not completed your refund will be issued by check DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits 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 Your Signature Your Phone Number Date Spouse s Signature If a joint return must sign Spouse s Phone Number Date Preparer s Name Preparer s Phone Number Date Firm s Name or Yours if Self Employed Preparer s PTIN Vendor Code Filing Election Code ID Theft PIN

You enter the total additions, subtractions, and deductions on the Virginia Schedule 763 ADJ.

Where do you enter the total additions, subtractions, and deductions on the Virginia Schedule 763 ADJ?

2022 Virginia Schedule 763 ADJ Page 1 VA3ADJ122888 Your Name Your SSN VA Dept of Taxation 2601045 763ADJ Rev 07 22 Additions to Adjusted Gross Income 1 Interest on obligations of other states exempt from federal income tax but not from state tax 1 00 2 Other additions to adjusted gross income 002a Fixed Date Conformity addition See instructions 2a Code 2b 2c Refer to the Form 763 instructions for Other Addition Codes 2b 2b 00 2c 2c 00 3 Total Additions Add Lines 1 2a 2c Enter here and on Form 763 Line 2 3 00 Subtractions from Adjusted Gross Income 4 Income interest dividends or gains from obligations or securities of the U S exempt from state income tax but not from federal tax 4 00 5 Disability income reported as wages or payments in lieu of wages on your federal return If claiming this subtraction you cannot also claim Age Deduction Claim the one that benefits you most 5a Enter YOUR disability subtraction on 5a 5a 00 5b Enter SPOUSE s disability subtraction on 5b if claiming Filing status 2 5b 00 6 Other Subtractions as provided in instructions 6a Fixed Date Conformity subtraction See instructions 6a 00 6b 6d Refer to the Form 763 instructions for Other Subtraction Codes Certification Number Code 6b 6b 00 6c 6c 00 6d 6d 00 7 Total Subtractions Add Lines 4 5a 5b and 6a 6d Enter here and on Form 763 Line 7 7 00 Deductions from Virginia Adjusted Gross Income Code 8 Refer to the Form 763 instructions for Deduction Codes 8a 8a 00 8b 8b 00 8c 8c 00 9 Total Deductions Add Lines 8a 8c Enter here and on Form 763 Line 13 9 00 Use Schedule ADJS if you are claiming more additions subtractions or deductions than the Schedule 763 ADJ allows Refer to the instructions for Other Codes Check this box VA3ADJ222888 2022 Virginia Schedule 763 ADJ Page 2 Your Name Your SSN Tax Credit for Low Income Individuals or Virginia Earned Income Credit SEE INSTRUCTIONS Family VAGI Name Social Security Number SSN Guideline Income Yourself 00 Spouse 00 Dependent 00 Dependent 00 10 If more than 4 exemptions enclose schedule listing the name SSN VAGI Enter total Family Guideline Income here 10 00 11 Enter the total number of exemptions reported in the table above Next go to the Poverty Guidelines Table shown in the Form 763 instruction book for this Line to see if you qualify for this credit 11 12 If you qualify enter the number of personal and dependent exemptions reported on your Form 763 see instructions 12 13 Multiply Line 12 by 300 Enter the result on Line 13 and proceed to Line 14 If you do not qualify for the Tax Credit for Low Income Individuals but claimed an Earned Income Credit on your federal return enter 0 and proceed to Line 14 13 00 14 Enter the amount of Earned Income Credit claimed on your federal return If you did not claim an Earned Income Credit on your federal return enter 0 14 00 15 Multiply Line 14 by 20 20 15 00 16 Enter the greater of Line 13 or Line 15 16 00 17 Compare the amount on Line 16 above to the amount of tax on Form 763 Line 18 Enter the lesser of the two amounts here and on Form 763 Line 23 This is your credit amount 17 00 Addition to Tax Penalty and Interest 18 Addition to tax 18 00 19 Penalty Late Filing Penalty Extension Penalty 19 00 20 Interest accrued on the tax you owe 20 00 21 Total Addition to Tax Penalty and Interest add Lines 18 20 Enter here and on Form 763 Line 32 21 00

The Virginia Adjusted Gross Income (VAGI) is not given in the provided information.

What is the Virginia Adjusted Gross Income (VAGI)?

LTD St ap le F or m s W 2 W 2 G 1 09 9 R a nd V K 1 h er e St ap le c he ck o r m on ey o rd er h er e 2011 Virginia Part Year Resident Income Tax Return Due May 1 2012 STAPLE HERE VA760P111888 Form 760PY Page 1 B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 1 AdjuSTEd GROSS INcOmE from Sch of Income Part 1 Line 7 column 1 1 00 00 2 Additions from Schedule 760PY Adj Line 3 2 00 00 3 Add Lines 1 and 2 3 00 00 4 Qualifying age deduction complete Age deduction Worksheet in instructions Enter Spouse s Age deduction on Line 4b column B when using Filing Status 4 ONLY Otherwise claim Your Age deduction on Line 4a column A and Spouse s on Line 4b column A 4a 00 4b 00 00 5 Social Security Act and equivalent Tier 1 Railroad Retirement Act benefits reported as taxable income on federal return and attributable to your period of residence in Virginia 5 00 00 6 State income tax refund or overpayment credit reported as income on your federal return and received while a Virginia resident claim in the same column you reported the income on Line 1 6 00 00 7 Income attributable to your period of residence outside Virginia from Schedule of Income Part 1 Line 9 column 3 7 00 00 8 Subtractions from Schedule 760PY Adj Line 7 8 00 00 9 Add Lines 4a 4b 5 6 7 and 8 9 00 00 10 Virginia Adjusted Gross Income VAGI Subtract Line 9 from Line 3 10 00 00 2601039 Rev 02 11 EXEMPTIONS Enter the number of exemptions being claimed in the appropriate column See Prorated Exemptions Worksheet from Schedule of Income Part 2 1 Single use column A claiming federal Head of Household YES 2 Married Filing Joint Return use column A Even if only one had income 3 Married Filing Separate Returns use column A Enter spouse s SSN above Enter spouse s full name on line below 4 Married Filing Separately on this Combined Return use column A You column B Spouse B Spouse Filing Status 4 ONLY A You and Spouse if Filing Status 2 You Spouse dependents 65 or over Blind FILING STATuS ChECK ONLY ONE FILING INFORMATION Amended Return check if Result of NOL Overseas on due date dependent on Another s Return Qualifying Farmer Fisherman or merchant Seaman I we authorize the department of Taxation to discuss this return with my our preparer Earned Income credit claimed on Federal Return 00 combined Social Security for You and Spouse reported as taxable income on Federal Return 00 See instructions before completing line items Attach a complete copy of your federal tax return and all other required Virginia attachments Complete the Schedule of Income first and be sure to submit it with your Form 760PY For Local use coding v You Birth date mm dd yyyy Spouse Birth date mm dd yyyy Dates of VA Residence mm dd yyyy YOuR First Name mI Your Last Name Check if deceased Suffix A Your Social Security Number You From You To SPOuSE S First Name filing status 2 or 4 mI Spouse s Last Name Check if deceased Suffix B Spouse s Social Security Number Spouse From Spouse To Present Home Address Number and Street or Rural Route city Town or Post Office State ZIP code Locality code Your Business Phone Number Your Home Phone Number Spouse s Business Phone Number Preparer s PTIN Filing Election code VA760P211888 Form 760PY 2011 Page 2 Your Name Your SSN 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 Please Sign here Your Signature date Spouse s Signature If a joint return both must sign date Preparer s use Only Preparer s Signature date Firm s Name or Yours if Self Employed Preparer s Phone Number B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 11 Itemized deductions paid while a Virginia resident See instructions 11 00 00 12 State and local income taxes on Federal Schedule A and included on Line 11 12 00 00 13 Subtract Line 12 from Line 11 if claiming itemized deductions Otherwise enter standard deduction from Standard deductions Worksheet in instructions 13 00 00 14 Prorated exemption amount from Schedule of Income Part 2 Line 11 14 00 00 15 deductions from Schedule 760PY Adj Line 9 15 00 00 16 Add Lines 13 14 and 15 16 00 00 17 Virginia Taxable Income Subtract Line 16 from Line 10 17 00 00 18 Tax amount from Tax Table or Tax Rate Schedule 18 00 00 19 Total Tax Add Line 18 Column A and Line 18 Column B 19 00 20a Your Virginia income tax withheld Attach Forms W 2 W 2G 1099 and VK 1 20a 00 20b Spouse s Virginia income tax withheld Attach Forms W 2 W 2G 1099 and VK 1 20b 00 21 combined 2011 Estimated Tax Payments Include credit from 2010 21 00 22 Extension Payment Enter amount paid on Form 760IP 22 00 23 Tax credit for Low Income Individuals or Virginia Earned Income credit from Schedule 760PY Adj Line 17 23 00 24 Total credit for taxes paid to another state from Schedule OSc 24 00 25 credits from Schedule cR Section 5 Line 1A If claiming Political contribution credit only check box 25 00 26 Total payments and credits Add Lines 20a 20b 21 22 23 24 and 25 26 00 27 If Line 19 is larger than Line 26 enter the difference This is the INCOME TAX YOu OWE Skip to Line 30 27 00 28 If Line 26 is larger than Line 19 enter the difference This is the OVERPAYMENT AMOuNT 28 00 29 Amount of overpayment on Line 28 to be CREDITED TO 2012 ESTIMATED INCOME TAX 29 00 30 Adjustments and Voluntary contributions from attached Schedule 760PY Adj Line 24 30 00 31 Add Lines 29 and 30 31 00 32 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 Line 28 enter the difference This is the AMOuNT YOu OWE Attach payment check here if credit card payment has been made 32 00 33 If Line 28 is larger than Line 31 subtract Line 31 from Line 28 This is the amount to be REFuNDED TO YOu 33 00 Direct Deposit Information Checking SavingsAccount Type Your bank routing transit number Your bank account number Attach a complete copy of your federal tax return and all other required Virginia attachments For domestic direct deposit refunds only See instructions

The Virginia taxable income depends on the individual's residency status and whether their income is from Virginia sources. Part-year residents can subtract income attributable to residence outside Virginia from their federal adjusted gross income to compute their Virginia adjusted gross income (VAGI) and determine if it meets the minimum filing threshold. Nonresidents with Virginia Adjusted Gross Income at or above the filing threshold must file if any of their income is from Virginia sources, including income from labor performed, business done, or property located in Virginia. Virginia source income generally does not include personal savings account interest or dividends from an individual's stock market investments. Therefore, the Virginia taxable income varies depending on individual circumstances.

What is the Virginia taxable income?

VA0760121888 2021 Virginia Form 760 Resident Income Tax Return File by May 1 2022 USE BLACK INK2601031 Rev 07 21 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 State ZIP Code 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 Virginia Schedule A See instructions 10 11 If you do not claim itemized deductions on Line 10 enter standard deduction See instructions 11 12 Exemptions Sum of total from Exemption Section A plus Exemption Section B 12 13 Deductions from Schedule ADJ Line 9 13 14 Add Lines 10 11 12 and 13 14 15 Virginia Taxable Income Subtract Line 14 from Line 9 15 loss 00 00 loss 00 00 00 00 00 loss 00 00 00 00 loss 00 loss 00 loss 00 00 Exemptions Add Sections A and B Enter the sum on Line 12 X 930 1 Total Section A Spouse if Filing Status 2You Dependents 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 Reason Code Overseas on due date Federal Schedule C filed Earned Income Credit on federal return Amount claimed Spouse 00 00 You Social Security Number First 4 letters of last name You Spouse Filing Status Enter in box 1 Single 2 Joint and 3 Married Filing Separately Federal head of household Filing Status 1 only YESCode 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 X 800 Spouse 65 or over You 65 or over Spouse Blind You Blind Total Section B Issue DateVA Driver s License Information Customer ID You Spouse Birth Date mm dd yyyy Locality CodeYou Spouse Deceased LTD LAR DLAR DTD I we are uninsured and authorize the sharing of certain information from Form 760 and Schedule ADJ as described in the instructions with the Department of Medical Assistance Services DMAS for purposes of identifying persons who would like to newly enroll in medical assistance WEB VA0760221888 Page 2 2021 Form 760 Your SSN DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits Bank Routing Transit Number Checking SavingsBank Account Number 16 Amount of Tax from Tax Table or Tax Rate Schedule round to whole dollars 16 17 Spouse Tax Adjustment STA Filing Status 2 only Enter Spouse s VAGI in box here and STA amount on Line 17 17 18 Net Amount of Tax Subtract Line 17 from Line 16 18 19 Virginia income tax withheld for 2021 Enclose copies of Forms W 2 W 2G 1099 and or VK 1 19a Your Virginia withholding 19a 19b Spouse s Virginia withholding Filing Status 2 only 19b 20 Estimated tax payments for taxable year 2021 from Form 760ES 20 21 Amount of 2020 overpayment applied toward 2021 estimated tax 21 22 Extension Payments from Form 760IP 22 23 Tax Credit for Low Income Individuals or Earned Income Credit from Sch ADJ Line 17 23 24 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 24 25 Credits from enclosed Schedule CR Section 5 Part 1 Line 1A 25 26 Add Lines 19a through 25 26 27 If Line 26 is less than Line 18 subtract Line 26 from Line 18 This is the Tax You Owe 27 28 If Line 18 is less than Line 26 subtract Line 18 from Line 26 This is Your Tax Overpayment 28 29 Amount of overpayment you want credited to next year s estimated tax 29 30 Virginia529 and ABLE Contributions from Schedule VAC Section I Line 6 30 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 32 Addition to Tax Penalty and Interest from enclosed Schedule ADJ Line 21 32 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions fill in oval if no sales and use tax is due 33 34 Add Lines 29 through 33 34 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is less than Line 34 subtract Line 28 from Line 34 Enclose payment or pay at www tax virginia gov AMOUNT YOU OWE 35 fill in oval if paying by credit or debit card see instructions 36 If Line 28 is greater than Line 34 subtract Line 34 from Line 28 YOUR REFUND 36 If the Direct Deposit section below is not completed your refund will be issued by check e Preparer s PTINFirm 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 ElectionPhone 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 ID Theft PIN 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 loss 00 WEB

If filing a joint return under Filing Status 2 or 4, the complete name of the spouse and their SSN must be included on Form 760PY.

Who must include spouse's SSN on Form 760PY?

2019 Virginia Part Year Resident Income Tax Return Due May 1 2020 Form 760PY Page 1 Your Birth Date mm dd yyyy Spouse s Birth Date mm dd yyyy B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 00 00 1 FEDERAL ADJUSTED GROSS INCOME from Schedule of Income Part 1 Line 7 Column 1 1 2 Additions from Schedule 760PY ADJ Line 3 2 00 00 3 3 00 00 4 Qualifying Age Deduction Enter Birth Dates above Complete Age Deduction Worksheet in instructions Enter Spouse s Age Deduction on Line 4b Column B when using Filing Status 4 ONLY Otherwise claim Your Age Deduction on Line 4a Column A and Spouse s on Line 4b Column A 4a 00 4b 00 00 5 reported as taxable income on federal return and attributable to your period of residence in Virginia 5 00 00 6 State income tax refund or overpayment credit reported as income on your federal return and received while a Virginia resident Claim in the same column you reported adjusted gross income on Line 1 6 00 00 7 Income attributable to your period of residence outside Virginia from Schedule of Income Part 1 Line 9 Column 3 7 00 00 8 Subtractions from Schedule 760PY ADJ Line 7 8 00 00 9 9 00 00 10 10 00 00 11 Itemized Deductions from Virginia Schedule A See Instructions 11 00 00 12 If you do not claim itemized deductions on Line 11 enter standard deduction from Standard Deductions Worksheet in instructions 12 00 00 For Local Use DATE OF BIRTH LTD Va Dept of Taxation 2601039 Rev 8 19 Filing Status Enter Filing Status Code in box below 1 Single Column A Federal head of household YES 2 Married Filing Joint return Column A Married Filing Separate returns Column A 4 Married Filing Separately on this combined return Columns A and B 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 Exemptions Enter the number of exemptions being claimed You Spouse Dependents 65 or Over Blind A You Enter the numbers for both You and Spouse if Filing Status 2 B Spouse Filing Status 4 Only Check Boxes Amended Return Check if Result of NOL Qualifying Farmer Fisherman or Merchant Seaman Combined Social Security for You and Spouse reported as taxable income on Federal Return Dependent on Another s Return Earned Income Credit Claimed on federal return Overseas on Due Date Enclose a complete copy of your federal tax return and all other required Virginia enclosures Dates of VA Residence mm dd yyyy YOUR First Name MI Your Last Name Check if deceased A Your Social Security Number You From You To SPOUSE S MI Spouse s Last Name Check if deceased B Spouse s Social Security Number Spouse From Spouse To Present Home Address Number and Street or Rural Route VA Driver s License Information Customer ID You Spouse Issue Date mm dd yyyy You Spouse State ZIP Code Locality Code B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 13 Prorated exemption amount from Schedule of Income Part 2 Line 11 See instructions 13 00 00 14 Deductions from Schedule 760PY ADJ Line 9 14 00 00 15 15 00 00 16 16 00 00 17 Tax amount from Tax Table or Tax Rate Schedule 17 00 00 18 18 00 19a Your Virginia income tax withheld Enclose copies of Forms W 2 W 2G 1099 and VK 1 19a 00 19b Spouse s Virginia income tax withheld Enclose copies of Forms W 2 W 2G 1099 and VK 1 19b 00 20 Combined 2019 Estimated Tax Payments 20 00 21 2018 overpayment credited to 2019 estimated taxes 21 00 22 Extension Payment Enter amount paid on Form 760IP 22 00 23 Tax Credit for Low Income Individuals or Virginia Earned Income Credit from Schedule 760PY ADJ Line 17 23 00 24 Total credit for taxes paid to another state from Schedule OSC 24 00 25 Credits from Schedule CR Section 5 Line 1A 25 00 26 26 00 27 27 00 28 28 00 29 Amount of overpayment on Line 28 to be CREDITED TO 2020 ESTIMATED INCOME TAX 29 00 30 Virginia529 and ABLEnow Contributions from Schedule VAC Section I Line 6 30 00 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 00 32 Addition to Tax Penalty and Interest from enclosed Schedule 760PY ADJ Line 21 32 00 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions Check here if no sales and use tax is due 33 00 34 34 00 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is an overpayment and Line 34 is larger than AMOUNT YOU OWE Check here if paying by credit or debit card See instructions 35 00 36 If Line 28 is larger than Line 34 subtract Line 34 from Line 28 36 00 2019 Form 760PY Page 2 Your Name Your SSN I We authorize the Department of Taxation to discuss this return with my our preparer I agree to obtain my Form 1099 G at www tax virginia gov Your Bank Routing Transit Number Your Bank Account Number Checking Savings If the Direct Deposit section below is not completed your refund will be issued by check DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits 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 Your Signature Your Phone Number Date Spouse s Signature If a joint return must sign Spouse s Phone Number Date Preparer s Name Preparer s Phone Number Date Firm s Name or Yours if Self Employed Preparer s PTIN Vendor Code Filing Election Code ID Theft PIN

It depends on whether the taxpayer has multiple additions, subtractions, or deductions. If they do, they may be required to submit the new Schedule ADJS in addition to Schedule ADJ.

Does the taxpayer need to file a Schedule ADJ?

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 loss 00 00 loss 00 00 00 00 00 loss 00 00 00 00 00 loss 00 loss 00 loss 00 Locality Code 00 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 2You Dependents Last 5 Digits of VA Driver s License ID You Spouse Spouse 00 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 SavingsBank 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 e Preparer s PTINFirm 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 ElectionPhone 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 Use 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 loss 00

The state income tax refund or overpayment credit reported as income on federal return is the amount that needs to be entered on the Virginia return in the same column as it was reported on Line 6 of the federal return.

What is the state income tax refund or overpayment credit reported as income on federal return?

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 loss 00 00 loss 00 00 00 00 00 loss 00 00 00 00 00 loss 00 loss 00 loss 00 Locality Code 00 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 2You Dependents Last 5 Digits of VA Driver s License ID You Spouse Spouse 00 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 SavingsBank 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 e Preparer s PTINFirm 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 ElectionPhone 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 Use 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 loss 00

The tax credit for low-income individuals in Virginia is currently a nonrefundable credit equal to the greater of 20% of the federal earned income credit or the current Virginia low income credit, which provides a nonrefundable individual income tax credit equal to $300 for each personal and dependent exemption for taxpayers with family Virginia adjusted gross income at or below the federal poverty line.

How much is the tax credit for low-income individuals in Virginia?

2022 Virginia Schedule 763 ADJ Page 1 VA3ADJ122888 Your Name Your SSN VA Dept of Taxation 2601045 763ADJ Rev 07 22 Additions to Adjusted Gross Income 1 Interest on obligations of other states exempt from federal income tax but not from state tax 1 00 2 Other additions to adjusted gross income 002a Fixed Date Conformity addition See instructions 2a Code 2b 2c Refer to the Form 763 instructions for Other Addition Codes 2b 2b 00 2c 2c 00 3 Total Additions Add Lines 1 2a 2c Enter here and on Form 763 Line 2 3 00 Subtractions from Adjusted Gross Income 4 Income interest dividends or gains from obligations or securities of the U S exempt from state income tax but not from federal tax 4 00 5 Disability income reported as wages or payments in lieu of wages on your federal return If claiming this subtraction you cannot also claim Age Deduction Claim the one that benefits you most 5a Enter YOUR disability subtraction on 5a 5a 00 5b Enter SPOUSE s disability subtraction on 5b if claiming Filing status 2 5b 00 6 Other Subtractions as provided in instructions 6a Fixed Date Conformity subtraction See instructions 6a 00 6b 6d Refer to the Form 763 instructions for Other Subtraction Codes Certification Number Code 6b 6b 00 6c 6c 00 6d 6d 00 7 Total Subtractions Add Lines 4 5a 5b and 6a 6d Enter here and on Form 763 Line 7 7 00 Deductions from Virginia Adjusted Gross Income Code 8 Refer to the Form 763 instructions for Deduction Codes 8a 8a 00 8b 8b 00 8c 8c 00 9 Total Deductions Add Lines 8a 8c Enter here and on Form 763 Line 13 9 00 Use Schedule ADJS if you are claiming more additions subtractions or deductions than the Schedule 763 ADJ allows Refer to the instructions for Other Codes Check this box VA3ADJ222888 2022 Virginia Schedule 763 ADJ Page 2 Your Name Your SSN Tax Credit for Low Income Individuals or Virginia Earned Income Credit SEE INSTRUCTIONS Family VAGI Name Social Security Number SSN Guideline Income Yourself 00 Spouse 00 Dependent 00 Dependent 00 10 If more than 4 exemptions enclose schedule listing the name SSN VAGI Enter total Family Guideline Income here 10 00 11 Enter the total number of exemptions reported in the table above Next go to the Poverty Guidelines Table shown in the Form 763 instruction book for this Line to see if you qualify for this credit 11 12 If you qualify enter the number of personal and dependent exemptions reported on your Form 763 see instructions 12 13 Multiply Line 12 by 300 Enter the result on Line 13 and proceed to Line 14 If you do not qualify for the Tax Credit for Low Income Individuals but claimed an Earned Income Credit on your federal return enter 0 and proceed to Line 14 13 00 14 Enter the amount of Earned Income Credit claimed on your federal return If you did not claim an Earned Income Credit on your federal return enter 0 14 00 15 Multiply Line 14 by 20 20 15 00 16 Enter the greater of Line 13 or Line 15 16 00 17 Compare the amount on Line 16 above to the amount of tax on Form 763 Line 18 Enter the lesser of the two amounts here and on Form 763 Line 23 This is your credit amount 17 00 Addition to Tax Penalty and Interest 18 Addition to tax 18 00 19 Penalty Late Filing Penalty Extension Penalty 19 00 20 Interest accrued on the tax you owe 20 00 21 Total Addition to Tax Penalty and Interest add Lines 18 20 Enter here and on Form 763 Line 32 21 00

The total amount of itemized deductions cannot be determined without additional information.

What is the total amount of itemized deductions?

VA0760121888 2021 Virginia Form 760 Resident Income Tax Return File by May 1 2022 USE BLACK INK2601031 Rev 07 21 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 State ZIP Code 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 Virginia Schedule A See instructions 10 11 If you do not claim itemized deductions on Line 10 enter standard deduction See instructions 11 12 Exemptions Sum of total from Exemption Section A plus Exemption Section B 12 13 Deductions from Schedule ADJ Line 9 13 14 Add Lines 10 11 12 and 13 14 15 Virginia Taxable Income Subtract Line 14 from Line 9 15 loss 00 00 loss 00 00 00 00 00 loss 00 00 00 00 loss 00 loss 00 loss 00 00 Exemptions Add Sections A and B Enter the sum on Line 12 X 930 1 Total Section A Spouse if Filing Status 2You Dependents 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 Reason Code Overseas on due date Federal Schedule C filed Earned Income Credit on federal return Amount claimed Spouse 00 00 You Social Security Number First 4 letters of last name You Spouse Filing Status Enter in box 1 Single 2 Joint and 3 Married Filing Separately Federal head of household Filing Status 1 only YESCode 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 X 800 Spouse 65 or over You 65 or over Spouse Blind You Blind Total Section B Issue DateVA Driver s License Information Customer ID You Spouse Birth Date mm dd yyyy Locality CodeYou Spouse Deceased LTD LAR DLAR DTD I we are uninsured and authorize the sharing of certain information from Form 760 and Schedule ADJ as described in the instructions with the Department of Medical Assistance Services DMAS for purposes of identifying persons who would like to newly enroll in medical assistance WEB VA0760221888 Page 2 2021 Form 760 Your SSN DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits Bank Routing Transit Number Checking SavingsBank Account Number 16 Amount of Tax from Tax Table or Tax Rate Schedule round to whole dollars 16 17 Spouse Tax Adjustment STA Filing Status 2 only Enter Spouse s VAGI in box here and STA amount on Line 17 17 18 Net Amount of Tax Subtract Line 17 from Line 16 18 19 Virginia income tax withheld for 2021 Enclose copies of Forms W 2 W 2G 1099 and or VK 1 19a Your Virginia withholding 19a 19b Spouse s Virginia withholding Filing Status 2 only 19b 20 Estimated tax payments for taxable year 2021 from Form 760ES 20 21 Amount of 2020 overpayment applied toward 2021 estimated tax 21 22 Extension Payments from Form 760IP 22 23 Tax Credit for Low Income Individuals or Earned Income Credit from Sch ADJ Line 17 23 24 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 24 25 Credits from enclosed Schedule CR Section 5 Part 1 Line 1A 25 26 Add Lines 19a through 25 26 27 If Line 26 is less than Line 18 subtract Line 26 from Line 18 This is the Tax You Owe 27 28 If Line 18 is less than Line 26 subtract Line 18 from Line 26 This is Your Tax Overpayment 28 29 Amount of overpayment you want credited to next year s estimated tax 29 30 Virginia529 and ABLE Contributions from Schedule VAC Section I Line 6 30 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 32 Addition to Tax Penalty and Interest from enclosed Schedule ADJ Line 21 32 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions fill in oval if no sales and use tax is due 33 34 Add Lines 29 through 33 34 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is less than Line 34 subtract Line 28 from Line 34 Enclose payment or pay at www tax virginia gov AMOUNT YOU OWE 35 fill in oval if paying by credit or debit card see instructions 36 If Line 28 is greater than Line 34 subtract Line 34 from Line 28 YOUR REFUND 36 If the Direct Deposit section below is not completed your refund will be issued by check e Preparer s PTINFirm 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 ElectionPhone 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 ID Theft PIN 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 loss 00 WEB

The purpose of completing Form 763 ADJ is to report additions to federal adjusted gross income, subtractions from federal adjusted gross income, deductions from Virginia adjusted gross income, credit for low-income individuals, and addition to tax penalty and interest.

What is the purpose of completing Form 763 ADJ?

Avoid delays If completed submit Schedule 763 ADJ with Form 763 2015 Virginia Schedule 763 ADJ Form 763 ADJ Page 1 VA3ADJ115888 Your Name Your SSN VA Dept of Taxation 2601045 763ADJ REV 08 15 Additions to Adjusted Gross Income 1 Interest on obligations of other states exempt from federal income tax but not from state tax 1 00 2 Other additions to adjusted gross income 002a Fixed Date Conformity addition See instructions 2a 2b 2c Refer to the Form 763 instructions for Other Addition Codes 2b 2b 00 2c 2c 00 3 Total Additions Add Lines 1 2a 2c Enter here and on Form 763 Line 2 3 00 Subtractions from Adjusted Gross Income 4 Income interest dividends or gains from obligations or securities of the U S exempt from state income tax but not from federal tax 4 00 5 Disability income reported as wages or payments in lieu of wages on your federal return If claiming this subtraction you cannot also claim Age Deduction Claim the one that benefits you most 5a Enter YOUR disability subtraction on 5a 5a 00 5b Enter SPOUSE s disability subtraction on 5b if claiming Filing status 2 5b 00 6 Other Subtractions as provided in instructions 6a Fixed Date Conformity subtraction See instructions 6a 00 6b 6d Refer to the Form 763 instructions for Other Subtraction Codes 6b 6b 00 6c 6c 00 6d 6d 00 7 Total Subtractions Add Lines 4 5a 5b and 6a 6d Enter here and on Form 763 Line 7 7 00 Deductions from Virginia Adjusted Gross Income 8 Refer to the Form 763 instructions for Deduction Codes 8a 8a 00 8b 8b 00 8c 8c 00 9 Total Deductions Add Lines 8a 8c Enter here and on Form 763 Line 14 9 00 VA3ADJ21588 2015 Virginia Schedule 763 ADJ Page 2 Your Name Your SSN Tax Credit for Low Income Individuals or Virginia Earned Income Credit SEE INSTRUCTIONS Family VAGI Name Social Security Number SSN Guideline Income Yourself 00 Spouse 00 Dependent 00 Dependent 00 10 If more than 4 exemptions enclose schedule listing the name SSN VAGI Enter total Family Guideline Income here 10 00 11 Enter the total number of exemptions reported in the table above Next go to the Poverty Guidelines Table shown in the Form 763 instruction book for this Line to see if you qualify for this credit 11 12 If you qualify enter the number of personal and dependent exemptions reported on your Form 763 see instructions 12 13 Multiply Line 12 by 300 Enter the result on Line 13 and proceed to Line 14 If you do not qualify for the Tax Credit for Low Income Individuals but claimed an Earned Income Credit on your federal return enter 0 and proceed to Line 14 13 00 14 Enter the amount of Earned Income Credit claimed on your federal return If you did not claim an Earned Income Credit on your federal return enter 0 14 00 15 Multiply Line 14 by 20 20 15 00 16 Enter the greater of Line 13 or Line 15 16 00 17 Compare the amount on Line 16 above to the amount of tax on Form 763 Line 19 Enter the lesser of the two amounts here and on Form 763 Line 24 This is your credit amount 17 00 Addition to Tax Penalty and Interest 18 Addition to tax Check if addition came from Form 760C Form 760F 18 00 19 Penalty Late Filing Penalty Extension Penalty 19 00 20 Interest accrued on the tax you owe 20 00 21 Total Addition to Tax Penalty and Interest add Lines 18 20 Enter here and on Form 763 Line 34 21 00

If you are a low income individual and have earned income, you may be eligible to claim the Earned Income Credit on your federal return. If you claimed the Earned Income Credit on your federal return, you can enter the amount on Line 10a or Line 11a depending on your eligibility for the Tax Credit for Low Income Individuals. If you did not claim the Earned Income Credit on your federal return, you can enter 0 on Line 10a or Line 11a. Therefore, whether or not you can claim the Earned Income Credit depends on your eligibility and whether you claimed it on your federal return.

Can you claim earned income credit?

VA0760122888 2022 Virginia Form 760 Resident Income Tax Return File by May 1 2023 USE BLACK INK2601031 Rev 06 22 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 State ZIP Code 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 Virginia Schedule A See instructions 10 11 If you do not claim itemized deductions on Line 10 enter standard deduction See instructions 11 12 Exemptions Sum of total from Exemption Section A plus Exemption Section B 12 13 Deductions from Schedule ADJ Line 9 13 14 Add Lines 10 11 12 and 13 14 15 Virginia Taxable Income Subtract Line 14 from Line 9 15 loss 00 00 loss 00 00 00 00 00 loss 00 00 00 00 loss 00 loss 00 loss 00 00 Exemptions Add Sections A and B Enter the sum on Line 12 X 930 1 Total Section A Spouse if Filing Status 2You Dependents 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 Reason Code Overseas on due date Federal Schedule C filed Earned Income Credit on federal return Amount claimed Spouse 00 00 You Social Security Number First 4 letters of last name You Spouse Filing Status Enter in box 1 Single 2 Joint and 3 Married Filing Separately Federal head of household Filing Status 1 only YESCode 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 X 800 Spouse 65 or over You 65 or over Spouse Blind You Blind Total Section B Issue DateVA Driver s License Information Customer ID You Spouse Birth Date mm dd yyyy Locality CodeYou Spouse Deceased LTD LAR DLAR DTD I we authorize the sharing of certain information from Form 760 and Schedule HCI as described in the instructions with the Department of Medical Assistance Services DMAS and the Department of Social Services DSS for purposes of identifying persons who would like to newly enroll in medical assistance WEB VA0760222888 Page 2 2022 Form 760 Your SSN DIRECT BANK DEPOSIT Domestic Accounts Only No International Deposits Bank Routing Transit Number Checking SavingsBank Account Number 16 Amount of Tax from Tax Table or Tax Rate Schedule round to whole dollars 16 17 Spouse Tax Adjustment STA Filing Status 2 only Enter Spouse s VAGI in box here and STA amount on Line 17 17 18 Net Amount of Tax Subtract Line 17 from Line 16 18 19 Virginia income tax withheld for 2022 Enclose copies of Forms W 2 W 2G 1099 and or VK 1 19a Your Virginia withholding 19a 19b Spouse s Virginia withholding Filing Status 2 only 19b 20 Estimated tax payments for taxable year 2022 from Form 760ES 20 21 Amount of 2021 overpayment applied toward 2022 estimated tax 21 22 Extension Payments from Form 760IP 22 23 Tax Credit for Low Income Individuals or Earned Income Credit from Sch ADJ Line 17 23 24 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 24 25 Credits from enclosed Schedule CR Section 5 Part 1 Line 1A 25 26 Add Lines 19a through 25 26 27 If Line 26 is less than Line 18 subtract Line 26 from Line 18 This is the Tax You Owe 27 28 If Line 18 is less than Line 26 subtract Line 18 from Line 26 This is Your Tax Overpayment 28 29 Amount of overpayment you want credited to next year s estimated tax 29 30 Virginia529 and ABLE Contributions from Schedule VAC Section I Line 6 30 31 Other Voluntary Contributions from Schedule VAC Section II Line 14 31 32 Addition to Tax Penalty and Interest from enclosed Schedule ADJ Line 21 See instructions enclose 760c or 760F and Fill in oval 32 33 Sales and Use Tax is due on Internet mail order and out of state purchases Consumer s Use Tax See instructions Fill in oval iF no sales and use tax is due 33 34 Add Lines 29 through 33 34 35 If you owe tax on Line 27 add Lines 27 and 34 OR If Line 28 is less than Line 34 subtract Line 28 from Line 34 Enclose payment or pay at www tax virginia gov AMOUNT YOU OWE 35 Fill in oval iF paying by credit or debit card see instructions 36 If Line 28 is greater than Line 34 subtract Line 34 from Line 28 YOUR REFUND 36 If the Direct Deposit section below is not completed your refund will be issued by check e Preparer s PTINFirm 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 ElectionPhone 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 ID Theft PIN 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 loss 00 WEB

The total amount of tax owed by the filer according to Form 763 cannot be determined from the provided information.

What is the total amount of tax owed by the filer according to Form 763?

2010 Virginia Schedule 763 ADJ Form 763 ADJ Page 1 VA3ADJ110000 Avoid delays If completed attach Schedule 763 ADJ to Form 763 Your Name Your SSN Additions to Adjusted Gross Income 1 Interest on obligations of other states exempt from federal income tax but not from state tax 1 00 2 Other additions to adjusted gross income 002a Fixed Date Conformity addition See instructions 2a 2b 2c Refer to the Form 763 instructions for Other Addition Codes 2b 2b 00 2c 2c 00 3 Total Additions Add Lines 1 2a 2c Enter here and on Form 763 Line 2 3 00 Subtractions from Adjusted Gross Income 4 Income interest dividends or gains from obligations or securities of the U S exempt from state income tax but not from federal tax 4 00 5 Disability income reported as wages or payments in lieu of wages on your federal return If claiming this subtraction you cannot also claim Age Deduction Claim the one that benefits you most 5a Enter YOUR disability subtraction on 5a 5a 00 5b Enter SPOUSE s disability subtraction on 5b if claiming Filing status 2 5b 00 6 Other Subtractions as provided in instructions 6a Fixed Date Conformity subtraction See instructions 6a 00 6b 6d Refer to the Form 763 instruction book for Other 6b 6b 00 Subtraction Codes 6c 6c 00 6d 6d 00 7 Total Subtractions Add Lines 4 5a 5b and 6a 6d Enter here and on Form 763 Line 7 7 00 Deductions from Virginia Adjusted Gross Income 8 Refer to the Form 763 Instructions for Deduction Codes 8a 8a 00 8b 8b 00 8c 8c 00 9 Total Deductions Add Lines 8a 8c Enter here and on Form 763 Line 14 9 00 VA Dept of Taxation 2601045 763ADJ REV 09 10 VA3ADJ210000 2010 Virginia Schedule 763 ADJ Page 2 Your Name Your SSN Tax Credit For Low Income Individuals or Virginia Earned Income Credit SEE INSTRUCTIONS Family VAGI Name Social Security Number SSN Virginia Adjusted Gross Income VAGI Yourself 00 Spouse 00 a Dependent 00 b Dependent 00 10 If more than 4 exemptions attach schedule listing the name SSN VAGI Enter total Family VAGI here 10 00 11 Enter the total number of exemptions reported in the table above Next go to the Poverty Guideline Table shown in the Form 763 instruction book for this Line to see if you qualify for this credit 11 12 If you qualify enter the number of personal exemptions reported on your Form 763 12 13 Multiply Line 12 by 300 Enter the result on Line 13 and proceed to Line 14 If you do not qualify for the Tax Credit for Low Income Individuals but claimed an Earned Income Credit on your fed eral return enter 0 and proceed to Line 14 13 00 14 Enter the amount of Earned Income Credit claimed on your federal return If you did not claim an Earned Income Credit on your federal return enter 0 14 00 15 Multiply Line 14 by 20 20 15 00 16 Enter the greater of Line 13 or Line 15 16 00 17 Compare the amount on Line 16 above to the amount of tax on Form 763 Line 19 Enter the lesser of the two amounts here and on Form 763 Line 23 This is your credit amount 17 00 Adjustments and Voluntary Contributions 18 Addition to tax Check if addition came from Form 760C Form 760F 18 00 19 Penalty Late Filing Penalty Extension Penalty 19 00 20 Interest interest accrued on the tax you owe 20 00 21 Consumer s Use Tax 21 00 22 Voluntary Contributions Enter the code for the contribution s and the contribution amount s in boxes 22a 22c If contributing to more than 3 Voluntary Con tributions see Form 763 instructions 22a 22a 00 22b 22b 00 22c 22c 00 23 If contributing to a School Foundation or a Library Foundation enter the code for the foundation s and the contribution amount s in boxes 23a 23c If contributing to more than 3 school or library foundations see Form 763 instructions 23a 23a 00 23b 23b 00 23c 23c 00 24 Total Adjustments add Lines 18 23c Enter here and on Form 763 Line 30 24 00

It is unclear from the provided information whether the taxpayer has any federal head of household filing status reported on their return.

Does the taxpayer have any federal head of household filing status reported on their return?

loss VA0760110000 2010 Virginia Resident Form 760 Individual Income Tax Return 1 Single 2 Married filing joint return Enter spouse s SSN above 3 Married filing separate return Enter spouse s SSN above Did you claim federal head of household Yes Fill in oval to indicate status minus 10a Total Itemized Deductions 10b State and Local Income Taxes claimed on Sch A Locality Code See instructions Your first name M I Last name Number and Street If this is a change you must fill in oval City town or post office and state ZIP Code Your Social Security Number First 4 letters of your last name Spouse s Social Security Number First 4 letters of spouse s last name ExemptionsFiling Status reported as taxable on federal return F or m s W 2 W 2 G 1 09 9 an d V K 1 re po rti ng V A w ith ho ld in g h er e Spouse s Name 00 1 Federal Adjusted Gross Income 1 2 Total Additions from attached Schedule ADJ Line 3 2 3 Add Lines 1 and 2 3 4 Deduction for age on January 1 2011 See Instructions 4 5 Social Security Act and equivalent Tier 1 Railroad Retirement Act benefits 5 6 State Income Tax refund or overpayment credit reported as income on federal return 6 7 Subtractions from attached 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 9 10 Deductions Enter Standard Filing Status 1 3 000 2 6 000 3 3 000 OR Itemized 10 11 Exemptions Sum of total from Exemption Section A multiplied by 930 plus sum of total from Exemption Section B multiplied by 800 11 12 Deductions from Virginia Adjusted Gross Income Schedule ADJ Line 9 12 13 Add Lines 10 11 and 12 13 14 Virginia Taxable Income Subtract Line 13 from Line 9 14 loss loss loss You must use ItemIzed deductIons If You ItemIzed on Your federal return Office Use You must attach Schedule ADJ You must attach Schedule ADJ s ta pl e pa ym en t h er e ST A PL E STAPLE LTD LAR DLAR Spouse s first name joint returns only M I Last name ST A PL E Suffix Suffix 26 01 03 1 8 1 0 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 You Spouse Dependents You 65 or over Spouse 65 or over You Blind Spouse Blind Total Total A B Spouse You x 930 x 800 Your Birthday mm dd yy Spouse s Birthday mm dd yy 00 Add the Dollar Amounts and Enter Total on Line 11 Fill in all ovals that apply name or filing status has changed since last filing Virginia return was not filed last year Dependent on another s return Amended Return Fill in oval if result of NOL I We authorize the Dept of Taxation to discuss my our return with my our preparer v File by May 2 2011 PLEASE USE BLACK INK 00 loss loss DTD from federal return NOT FEDERAL TAXABLE INCOME 15 Amount of Tax from Tax Table or Tax Rate Schedule round to whole dollars 15 16 Spouse Tax Adjustment For Filing Status 2 only Enter VAGI in whole dollars below See instructions 16 17 Net Amount of Tax Subtract Line 16 from Line 15 17 18 Virginia tax withheld for 2010 18a Your Virginia withholding 18a 18b Spouse s Virginia withholding filing status 2 only 18b 19 Estimated Tax Paid for tax year 2010 from Form 760ES 19 include overpayment credited from tax year 2009 20 Extension Payments from Form 760IP 20 21 Tax Credit for Low Income Individuals or Earned Income Credit from attached Sch ADJ Line 17 21 22 Credit for Tax Paid to Another State from attached Sch OSC Line 21 22 23 Other Credits from attached Schedule CR 23 24 Add Lines 18a 18b and 19 through 23 24 25 If Line 24 is less than Line 17 subtract Line 24 from Line 17 This is the Tax You Owe 25 Skip to Line 28 26 If Line 17 is less than Line 24 subtract Line 17 from Line 24 This is Your Tax Overpayment 26 27 Amount of overpayment you want credited to next year s estimated tax 27 28 Adjustments and Voluntary Contributions from attached Schedule ADJ Line 24 28 29 Add Lines 27 and 28 29 30 If you owe tax on Line 25 add Lines 25 and 29 OR If Line 26 is less than Line 29 subtract Line 26 from Line 29 AMOUNT YOU OWE 30 fill in oval if paying by credit or debit card see instructions 31 If Line 26 is greater than Line 29 subtract Line 29 from Line 26 YOUR REFUND 31 Your SSN VA0760210000 16a Enter Your VAGI below Direct Deposit Information 16b Enter Spouse s VAGI below CREDIT CARD Page 2 Form 760 Year 2010 loss loss 00 00 You must attach Schedule ADJ You must attach Sch OSC and a copy of all other state returns Qualifying farmer fisherman or merchant seaman If claiming Political Contribution Credit only fill in oval see instructions Fill in all ovals that apply Spouse Deceased Overseas on due date 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Federal Schedule C filed with your federal return Your business phone number Home phone number Spouse s business phone number Preparer s FEIN PTIN SSN Preparer s Name Address Phone Number please print 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 Signature v Primary Taxpayer Deceased Earned Income Credit claimed on your federal return Amount claimed Checking SavingsAccount Type Your bank routing transit numbers Do not use direct deposit to transfer funds outside the United States See instructions Your bank account numbers Filing Election

The purpose of Schedule PY ADJS is to provide taxpayers with the ability to list multiple additions, subtractions, or deductions without having to enclose a separate explanation regarding each modification, in addition to Schedule 760PY ADJ.

What is the purpose of Schedule PY ADJS?

2022 Virginia Schedule 760PY ADJ Page 1 VAPADJ122888 Your Name Your SSN Additions to Adjusted Gross Income B Spouse Filing Status 4 ONLY A You Include Spouse if Filing Status 2 1 Interest earned while a Virginia resident on obligations of other states exempt from federal income tax but not from state tax 1 00 00 2 Other additions to adjusted gross income 00 002a Fixed date conformity addition See instructions 2a 2b 2c Refer to Form 760PY Instructions for Other Addition Codes Code 2b 2b 00 00 2c 2c 00 00 3 Total Additions Add Lines 1 2a 2c Enter here and on Form 760PY Line 2 3 00 00 Subtractions from Adjusted Gross Income B Spouse A You 4 Income interest dividends or gains received while a Virginia resident from obligations or securities of the U S exempt from state income tax but not from federal tax 4 00 00 5 Disability income received while a Virginia resident and reported as wages or payments in lieu of wages on your federal return If claiming this subtraction you cannot also claim Age Deduction Claim the one that benefits you most 5a Enter YOUR disability subtraction on Line 5a Column A 5a 00 5b Enter SPOUSE S disability subtraction on Line 5b Column B if claiming Filing Status 4 or Line 5b Column A if claiming Filing Status 2 5b 00 00 6 Other subtractions as provided in instructions 6a Fixed date conformity subtraction 6a 00 00 6b 6d See Form 760PY Instructions for Other Subtraction Codes Certification Number Code 6b 6b 00 00 6c 6c 00 00 6d 6d 00 00 7 Total subtractions Add Lines 4 5a 5b and 6a 6d Enter here and on Form 760PY Line 8 7 00 00 Deductions from Virginia Adjusted Gross Income B Spouse A You 8 Deduction codes See Form 760PY Instructions for Deduction Codes Code 8a 8a 00 00 8b 8b 00 00 8c 8c 00 00 9 Total Deductions Add Lines 8a 8c Enter here and on 760PY Line 14 9 00 00 Use Schedule PY ADJS if you are claiming more additions subtractions or deductions than the Schedule 760PY ADJ allows Refer to the instructions for Other Codes Check this box VAPADJ222888 2022 Virginia Schedule 760PY ADJ Page 2 Your Name Your SSN VA Dept of Taxation 2601038 760PYADJ Rev 07 22 Tax Credit for Low Income Individuals or Virginia Earned Income Credit List below the name Social Security Number SSN and Guideline Income for you your spouse and each dependent If more room is needed enclose a schedule with the name SSN and Guideline Income for each additional dependent Failure to complete Lines 10 17 may result in this credit being reduced or disallowed Family VAGI Name Social Security Number SSN Guideline Income You 00 Spouse 00 Dependent 00 Dependent 00 10 Total Family Guideline Income Be sure to include information from enclosed schedule if applicable 10 00 11 Enter the total number of exemptions reported in the table above and on any enclosed schedule Based on this total the total Family Guideline Income from Line 10 and the poverty guidelines in the instructions determine your eligibility 11 12 If you qualify enter the number of personal and dependent exemptions reported on your Form 760PY see instructions 12 13 Multiply Line 12 by 300 Enter the result on Line 13 and proceed to Line 14 13 00 14 Enter the amount of Earned Income Credit claimed on your federal return If you did not claim an Earned Income Credit on your federal return enter 0 If you are married filing separately see the instructions 14 00 15 Multiply Line 14 by 20 20 15 00 16 Enter the greater of Line 13 or Line 15 16 00 17 Compare the amount on Line 16 above to the amount of tax on Form 760PY Line 18 Enter the lesser of the two amounts here and on Form 760PY Line 23 This is your credit amount 17 00 Addition to Tax Penalty and Interest 18 Addition to tax 18 00 19 Penalty Late Filing Penalty Extension Penalty 19 00 20 Interest accrued on the tax you owe 20 00 21 Total Addition to Tax Penalty and Interest add Lines 18 20 Enter here and on Form 760PY Line 32 21 00