2019 Virginia Resident Form 760

2601031
Individual Income Tax Return
File by May 1, 2020 — PLEASE USE BLACK INK

Rev. 6/19
First 4 letters
Social Security Number of last name
<RXU¿UVWQDPH M.I. /DVWQDPHLQFOXGLQJVXI¿[
You - -
6SRXVH¶V¿UVWQDPHMRLQWUHWXUQVRQO\ M.I. /DVWQDPHLQFOXGLQJVXI¿[
Spouse - -
1XPEHUDQG6WUHHW,IWKLVLVDFKDQJH\RXPXVW¿OOLQRYDO %LUWK'DWHPPGG\\\\ Deceased Locality
Code
You - -
&LW\WRZQRUSRVWRI¿FH State ZIP Code
Spouse - -
VA Driver’s License Information
)LOOLQDOORYDOVWKDWDSSO\: Customer ID Issue Date
Name or Filing Status changed Overseas on due date
)HGHUDO6FKHGXOH&¿OHG
You - -
Virginia return not ¿OHGODVW\HDU
Dependent on another’s return Earned Income Credit
on federal return Spouse - -
4XDOLI\LQJIDUPHU¿VKHUPDQRU
merchant seaman Amount claimed: Exemptions Add Sections A and B. Enter the sum on Line 12.
Spouse if
Amended Return - Result of NOL? YES , You Filing Status 2 Dependents Total Section A

Filing Status Enter in box (1 = Single, 2 = Joint, and 3 = Married Filing Separately) 1 + + = X $930 =
Code
Federal head of household? YES You 65 Spouse 65 You Spouse
or over or over Blind Blind Total Section B
If Filing Status 3, enter spouse's SSN in the Spouse's Social Security Number
+ + + = X $800 =
ER[DWWRSRIIRUPDQGenter Spouse’s Name_______________________________

'R\RXQHHGWRÀOH"6HH/LQHDQG,QVWUXFWLRQV LOSS

1. $GMXVWHG*URVV,QFRPHIURPIHGHUDOUHWXUQ - Not federal taxable income .......................................1 , , . 00

2. Additions from HQFORVHGSchedule ADJ, Line 3....................................................................................2 , , . 00

LOSS
3. $GG/LQHVDQG ................................................................................................................................3 , , . 00
4. Age Deduction. See Instructions. Be sure to provide date of birth above.
You . 00 + 6SRXVH . 00 = 4
, . 00
, ,
 6RFLDO6HFXULW\DQGHTXLYDOHQW7LHU5DLOURDG5HWLUHPHQWEHQH¿WVLIWD[DEOHRQIHGHUDOUHWXUQ ...........5 , , . 00

 6WDWH,QFRPH7D[UHIXQGRURYHUSD\PHQWFUHGLWUHSRUWHGDVLQFRPHRQIHGHUDOUHWXUQ ......................6 , , . 00

7. Subtractions from HQFORVHGSchedule ADJ, Line 7 ..............................................................................7 , , . 00

8. $GG/LQHVDQG ........................................................................................................................8 , , . 00
9. 9LUJLQLD$GMXVWHG*URVV,QFRPH9$*,Subtract Line 8 from Line 3. Enter the result on this line. LOSS

Note:,IOHVVWKDQIRU)LOLQJ6WDWXVRURUIRU)LOLQJ6WDWXV\RXUWD[LV .... , , . 00

10. Itemized Deductions from Virginia Schedule A. See instructions. .......................................................10 , , . 00

11. If you do not claim itemized deductions on Line 10, enter standard deduction. See instructions. ...... 11 , , . 00

12. ([HPSWLRQV6XPRIWRWDOIURP([HPSWLRQ6HFWLRQ$SOXV([HPSWLRQ6HFWLRQ% .................................12 , , . 00

LOSS

13. Deductions from Schedule ADJ, Line 9 ...............................................................................................13 , , . 00

LOSS

14. $GG/LQHVDQG ..............................................................................................................14 , , . 00

LOSS
15. 9LUJLQLD7D[DEOH,QFRPH6XEWUDFW/LQHIURP/LQH ................................................................15 , , . 00

/$5 '/$5 '7' /7' $_________

)RUP
3DJH
 Your SSN - -

 $PRXQWRI7D[IURP7D[7DEOHRU7D[5DWH6FKHGXOHURXQGWRZKROHGROODUV ...................................16

, , . 00
 6SRXVH7D[$GMXVWPHQW67$)LOLQJ6WDWXV
only. Enter Spouse’s 9$*,LQER[KHUH Î LOSS

DQGSTA amount on Line 17. , , . 00 17 . 00

18. 1HW$PRXQWRI7D[6XEWUDFW/LQHIURP/LQH .......................................................................18 , , . 00

 9LUJLQLDLQFRPHWD[ZLWKKHOGIRU(QFORVHFRSLHVRI)RUPV::*DQGRU9.
19a. Your Virginia withholding ..........................................................................................................D , , . 00

 E6SRXVH¶V9LUJLQLDZLWKKROGLQJ)LOLQJ6WDWXVRQO\ .................................................................E , , . 00

 (VWLPDWHGWD[SD\PHQWVIRUWD[DEOH\HDUIURP)RUP(6....................................................20 , , . 00

 $PRXQWRIRYHUSD\PHQWDSSOLHGWRZDUGHVWLPDWHGWD[......................................................21 , , . 00

 ([WHQVLRQ3D\PHQWVIURP)RUP,3 .............................................................................................22 , , . 00

23. 7D[&UHGLWIRU/RZ,QFRPH,QGLYLGXDOVRU(DUQHG,QFRPH&UHGLWIURP6FK$'-/LQH .........................23
, , . 00
 &UHGLWIRU7D[3DLGWR$QRWKHU6WDWHIURP6FKHGXOH26&/LQH
You must enclose Schedule OSC and a copy of all other state returns. .............................................24 , , . 00

25. Credits from HQFORVHG6FKHGXOH&56HFWLRQ3DUW/LQH$ ....................................................25 , , . 00

26. $GG/LQHVDWKURXJK.................................................................................................................26 , , . 00

 ,I/LQHLVOHVVWKDQ/LQHVXEWUDFW/LQHIURP/LQH7KLVLVWKH7D[<RX2ZH ....................27 , , . 00

 ,I/LQHLVOHVVWKDQ/LQHVXEWUDFW/LQHIURP/LQH7KLVLV<RXU7D[2YHUSD\PHQW ...........28 , , . 00

 $PRXQWRIRYHUSD\PHQW\RXZDQWFUHGLWHGWRQH[W\HDU¶VHVWLPDWHGWD[ ............................................ , , . 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
 $GGLWLRQWR7D[3HQDOW\DQG,QWHUHVWIURPHQFORVHG6FKHGXOH$'-/LQH ....................................32 , , . 00
 6DOHVDQG8VH7D[LVGXHRQ,QWHUQHWPDLORUGHUDQGRXWRIVWDWHSXUFKDVHV&RQVXPHU¶V8VH7D[
See instructions. ......................... FILL IN OVAL IF NO SALES AND USE TAX IS DUE. ......................................33 , , . 00
34. $GG/LQHVWKURXJK...................................................................................................................34 , , . 00
 ,I\RXRZHWD[RQ/LQHDGG/LQHVDQG25If Line 28 is less than Line 34, subtract Line 28
from Line 34. Enclose payment or pay at ZZZWD[YLUJLQLDJRY............ $02817<282:( ......35 , , . 00
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. ............ <2855()81' ..............36 , , . 00
If the Direct Deposit section below is not completed, your refund will be issued by check.
',5(&7%$1.'(326,7 Bank Routing Transit Number Bank Account Number Checking Savings
Domestic Accounts Only.
No International Deposits.
,:HDXWKRUL]HWKH'HSWRI7D[DWLRQWRGLVFXVVWKLVUHWXUQZLWKP\RXUSUHSDUHU  ,DJUHHWRREWDLQP\)RUP*DWwww.tax.virginia.gov.
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 Date Spouse’s Signature Date

Your Spouse‘s ID Theft

Phone - - Phone - - PIN

Preparer’s Name Firm Name Phone Number Filing Election Preparer’s PTIN