Virginia Claim for Individual Income Tax Withheld
Extracted from PDF file 2019-virginia-form-763s.pdf, last modified January 2020
Claim for Individual Income Tax Withheld763-S Virginia Special Nonresident Claim For Individual Income Tax Withheld First Name MI 2019 Last Name 6Xႈ[ Present Home Address (Number and Street, Including Apartment Number or Rural Route) Spouse’s Social Security Number &LW\7RZQRU3RVW2ႈFH State Your Birthday (MM-DD-YYYY) - ZIP Code Amended Claim I (we) authorize the Department of Taxation to discuss my (our) return with my (our) preparer. Date of Birth Your Social Security Number 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. Check One: Maryland Pennsylvania West Virginia 3 Military Spouse Exemption: &RPSOHWH WKH VHFRQG SDJH RI WKLV IRUP ¿UVW WR SURYLGH LQIRUPDWLRQ regarding your eligibility for this exemption. 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 and your servicemember spouse must have the same non-Virginia domiciliary or legal state of residency or (2) you must elect to use the same residence for purposes of taxation as that of your servicemember spouse. If you are claiming this exemption, enter the 2 letter state abbreviation for the domiciliary or legal state of residency of your servicemember spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. I did not perform any services in Virginia and the Virginia tax was erroneously withheld from salary and wages paid to me by my employer. Enter the 2 letter state abbreviation for your domiciliary or legal state of residency . . . . . . . . . . . . STEP II - Enter amount of Virginia Tax withheld requested to be refunded: If amended, enter the full refund amount as it should have been reported on the original return. You must provide copies of your withholding statements. $ Va. Dept. of Taxation 763S F 2601046 Rev. 06/19 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 Checking Account Number Savings Due by May 1, 2020. Mail to the Department of Taxation, P.O. Box 1498, Richmond, Virginia 23218-1498. %RWKVSRXVHVPXVWFRPSOHWHDVHSDUDWH)RUP6ZKHQERWK¿OHUVKDYH9LUJLQLDLQFRPHWD[ZLWKKHOG I, the undersigned, do declare under penalties provided by law that this is a true, correct and complete return. Please Sign Here Your Signature X Preparer’s Preparer’s Name Use Only X Firm’s Name (or Yours if Self-employed) and Address Date Your Phone Date Preparer’s Phone Number Preparer’s FEIN/PTIN/SSN 2ႈFH8VH Code 0LOLWDU\6SRXVH4XDOL¿FDWLRQ Complete each question below and provide copies of the requested documentation before claiming Exemption Category 3 on the front of this form. Incomplete responses or missing documentation could cause your refund to be delayed. The provisions of the Servicemember Civil Relief Act apply only to spouses of military servicemembers and do not apply to dependents. I. Your spouse is a member of the armed forces present in Virginia in compliance with military orders. 1. Was your spouse in active military service for the taxable year in question? Yes No a. If your spouse was discharged from full-time military service, what was the date your spouse left the service? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _________________ MM/DD/YYYY b. If your spouse was in the military at any time for the taxable year in question, provide his or her duty station(s) for the taxable year. Additional rows are provided in case your spouse had more than one duty station during the taxable year. /RFDWLRQRI'XW\6WDWLRQLQFOXGHFRXQWU\LIQRW86$ Date Assignment Started MM/DD/YYYY Date Assignment Ended MM/DD/YYYY 2. Where and when were you and your spouse married? . . . . . . . State ______________ _________________ MM/DD/YYYY (QFORVHDFRS\RI\RXUPLOLWDU\,'FDUG7KLVZRXOGEHDPLOLWDU\LGHQWL¿FDWLRQFDUGLVVXHGWRVSRXVHV RIPLOLWDU\SHUVRQQHO,IDPLOLWDU\LGHQWL¿FDWLRQFDUGKDVQRWEHHQLVVXHGFKHFNKHUH 4. What is your spouse’s state of domicile or legal state of residency? (Enter here and on Line 3 on WKH¿UVWSDJHRIWKLVUHWXUQ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _________________ Enclose a copy of one or more of the following documents showing the military servicemember’s domicile or legal state of residency FKHFNWKHDSSURSULDWHER[HVWRLQGLFDWHZKLFKGRFXPHQWV\RXDUHSURYLGLQJ Leave & Earning Statement (LES) for the year in question Current driver’s license from the military servicemember’s domicile state '')RUP6WDWHRI/HJDO5HVLGHQFH&HUWL¿FDWH h Other _______________________________________________________________________________ II. You are present in Virginia solely to be with your spouse. 5. Do you own a business or any income producing property in Virginia? Yes No a. If yes, please describe. ___________________________________________________________________ III. You have the same non-Virginia domiciliary or legal state of residency as that of your servicemember spouse, or you elect to use the same non-Virginia state of residency as that of your servicemember spouse. 'LG\RX¿OHDVWDWHLQFRPHWD[UHWXUQIRUWKH\HDULQTXHVWLRQZLWKWKHVWDWHUHSRUWHG under question 4 above? Yes No If you answered yes, enclose a copy of your state income tax return for the year in question. If your state of residency for tax purposes does not have an income tax, check here. Note: A copy of documents requested above will assist the Department in speeding up the issuance of the refund.
2019 Form 763S, Virginia Special Nonresident Claim For Individual Income Tax Withheld
More about the Virginia Form 763S Individual Income Tax
We last updated the Claim for Individual Income Tax Withheld in January 2020, and the latest form we have available is for tax year 2019. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Virginia Department of Taxation. You can print other Virginia tax forms here.
Other Virginia Individual Income Tax Forms:
|Form Code||Form Name|
|Form 760||760 - Resident Individual Income Tax Return|
|Form VA-4||Employee's Withholding Exemption Certificate|
|Income Tax Instructions||Virginia Income Tax Instructional Booklet|
|Schedule ADJ||ScheduleADJ- VA ScheduleADJ|
|Form 760PY||Part-Year Resident Individual Income Tax Return|
Virginia usually releases forms for the current tax year between January and April. We last updated Virginia Form 763S from the Department of Taxation in January 2020.
About the Individual Income Tax
The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.
Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!
Historical Past-Year Versions of Virginia Form 763S
We have a total of nine past-year versions of Form 763S in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
2019 Form 763S, Virginia Special Nonresident Claim For Individual Income Tax Withheld
2018 Form 763S, Virginia Special Nonresident Claim For Individual Income Tax Withheld
2017 Form 763-S - Virginia Special Nonresident Claim For Individual Income Tax Withheld
Form 763-S 2016 Virginia Special Nonresident Claim For Individual Income Tax Withheld
While we do our best to keep our list of Virginia Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.