Get VA 763-S 2020-2021
Va. Dept. of Taxation 763S F 2601046 Rev. 03/19 STEP III - Avoid delays If you are a Resident of a State with an Individual Income Tax enclose a complete copy of your State of Residence Income Tax Return and check this box. 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 Your Bank Routing Transit Number Account Number Checking Savings Due by May 1 2019. Mail to the Department of Taxation P. O. Box 1498 Richmond Virginia 23218-1498. Both spouses must complete a separate Form 763-S when both filers have Virginia income tax withheld. 763-S Virginia Special Nonresident Claim For Individual Income Tax Withheld First Name MI Last Name VA763S118888 Suffix Present Home Address Number and Street Including Apartment Number or Rural Route Spouse s Social Security Number City Town or Post Office State I we authorize the Department of Taxation to discuss my our return with my our preparer. Your Birthday MM-DD-YYYY Date of Birth Your Social Security Number - ZIP Code Amended Claim Primary Taxpayer Deceased Include Federal Form 1310 if applicable STEP I - Select Exemption Category Review categories 1 - 4 below and enter the category number for which you are claiming an exemption* 1 Commuter State Exemption I declare that during the taxable year shown above I commuted on a daily basis from my place of residence to work in Virginia* My only income from sources within Virginia was from wages and salaries which are subject to taxation by the state or district checked below. I did not live in nor was I a domiciliary or legal resident of Virginia at any time. Check One District of Columbia Kentucky 2 Domiciliary State Exemption I declare that during the taxable year shown above I was a domiciliary or legal resident of the state checked below. My only income from sources within Virginia was from wages and salaries which are subject to taxation by the state checked below. I am not an actual resident of Virginia and I did not maintain a place of abode in Virginia for a total of more than 183 days. Maryland Pennsylvania West Virginia 3 Military Spouse Exemption Complete the second page of this form first. I declare that for the entire portion of the taxable year I lived in Virginia I was present in the state solely to be with my servicemember spouse who was on active military duty and in Virginia pursuant to military orders. To be exempt either 1 you must elect to use the same residence for purposes of taxation as that of your servicemember spouse. Enter the 2 letter state abbreviation for the domiciliary or legal state of residency of your servicemember spouse. or 2 you and your servicemember spouse must have the same non-Virginia domiciliary or legal state of residency. Enter the 2 letter domiciliary or legal state of residency. 4 Tax Withheld in Error by Employer I declare that during the taxable year shown above I was not a domiciliary or legal resident of Virginia at any time..
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