Form 763 S Virginia PDF Details

The Form 763 S Virginia is a state form that can be used to request information from the Virginia Department of Social Services (VDSS) about possible child abuse and/or neglect. The form can be used by parents, guardians, or other individuals who have reason to believe that a child may be experiencing abuse or neglect. The VDSS will review the submitted form and may contact the individual who submitted it for additional information.

QuestionAnswer
Form NameForm 763 S Virginia
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names 2021 Form 763S, Virginia Special Nonresident Claim For Individual Income Tax Withheld

Form Preview Example

763-S Virginia Special Nonresident Claim 2021

 

*VA763S121888*

For Individual Income Tax Withheld

 

 

 

 

First Name

MI

Last Name

 

Suffix

Your Social Security Number

 

 

 

 

 

 

 

 

Present Home Address (Number and Street, Including Apartment Number or Rural Route)

 

 

Spouse’s Social Security Number

 

 

 

 

 

 

 

 

City, Town or Post Office

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

I (we) authorize the Department of Taxation to discuss my (our) return with my (our) preparer.

 

Amended Claim

 

 

 

 

 

 

 

 

 

 

 

 

 

Va. Dept. of Taxation 763S F 2601046 Rev. 06/21

Date of Birth

Your Birthday

-

-

Primary Taxpayer Deceased (Include Federal Form 1310 if

 

(MM-DD-YYYY)

 

 

 

applicable)

 

 

 

STEP I - Select Exemption Category

Review categories 1 - 4 below and enter the category number for which you are claiming an exemption.

1Commuter 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

2Domiciliary 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

3Military Spouse Exemption: Complete the second page of this form first to provide information 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4Tax 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.

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

Your Bank Routing Transit Number

Account Number

 

 

Checking

 

 

Savings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Domestic Accounts Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No International Deposits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Due by May 1, 2022. 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.

I, the undersigned, do declare under penalties provided by law that this is a true, correct and complete return.

Please

Your Signature

Date

Your Phone

Office Use

Sign Here

X

 

 

 

 

 

 

 

 

 

 

Preparer’s

Preparer’s Name

Date

Preparer’s Phone Number

 

 

Use Only

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Firm’s Name (or Yours if Self-employed) and Address

 

Preparer’s FEIN/PTIN/SSN

 

Code

 

 

 

 

 

 

Military Spouse Qualification

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.

Location of Duty Station (include country if not USA)

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

3.Enclose a copy of your military ID card. This would be a military identification card issued to spouses of military personnel. If a military identification card has not been issued, check here.

4.What is your spouse’s state of domicile or legal state of residency? (Enter here and on Line 3 on

the first page of this return)

_________________

Enclose a copy of one or more of the following documents showing the military servicemember’s domicile or legal state of residency

(check the appropriate boxes to indicate which documents you are providing).

Leave & Earning Statement (LES) for the year in question

Current driver’s license from the military servicemember’s domicile state

DD Form 2058 (State of Legal Residence Certificate)

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.

6.Did you file a state income tax return for the year in question with the state reported under question 4 above?

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.

Yes

No

Note: A copy of documents requested above will assist the Department in speeding up the issuance of the refund.

How to Edit Form 763 S Virginia Online for Free

In case you want to fill out Virginia Special Nonresident Claim For Individual Income Tax Withheld, you don't need to download and install any sort of applications - simply try our PDF editor. The tool is consistently updated by us, acquiring awesome functions and becoming even more convenient. To begin your journey, consider these simple steps:

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Step 2: As you start the editor, you'll notice the form made ready to be filled in. Besides filling in various fields, you might also perform other actions with the form, that is putting on your own textual content, editing the original textual content, inserting illustrations or photos, placing your signature to the PDF, and more.

This form will involve some specific information; to guarantee accuracy, please make sure to consider the following recommendations:

1. The Virginia Special Nonresident Claim For Individual Income Tax Withheld usually requires particular details to be entered. Be sure that the subsequent blanks are completed:

A way to prepare Form 763 S Virginia step 1

2. Once your current task is complete, take the next step – fill out all of these fields - Domiciliary State Exemption I, Check One, Maryland, Pennsylvania, West Virginia, Military Spouse Exemption, Tax Withheld in Error by Employer, STEP II Enter amount of Virginia, If amended enter the full refund, STEP III Avoid delays If you are, complete copy of your State of, If the Direct Deposit section, Your Bank Routing Transit Number, Account Number, and Checking with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Filling out part 2 of Form 763 S Virginia

Concerning STEP III Avoid delays If you are and Account Number, ensure that you double-check them here. These two are certainly the key fields in the form.

3. Through this part, take a look at I the undersigned do declare under, Please Sign Here, Your Signature X, Preparers Use Only, Preparers Name X, Date, Date, Your Phone, Office Use, Preparers Phone Number, Firms Name or Yours if, Preparers FEINPTINSSN, Code, F S n o i t a x a T, and p e D. Every one of these will need to be filled in with utmost precision.

Part number 3 in completing Form 763 S Virginia

4. To move forward, the next part requires completing a handful of form blanks. Included in these are I Your spouse is a member of the, Was your spouse in active, Yes, If your spouse was discharged from, MMDDYYYY, If your spouse was in the military, Location of Duty Station include, Date Assignment Started, Date Assignment Ended, MMDDYYYY, MMDDYYYY, Where and when were you and your, MMDDYYYY, Enclose a copy of your military, and of military personnel If a, which are crucial to going forward with this PDF.

Completing section 4 of Form 763 S Virginia

5. Now, this last segment is what you will need to finish prior to closing the PDF. The fields in question are the following: Current drivers license from the, DD Form State of Legal Residence, Other, II You are present in Virginia, Do you own a business or any, Yes, If yes please describe, III You have the same nonVirginia, or you elect to use the same, Did you file a state income tax, under question above, Yes, If you answered yes enclose a copy, If your state of residency for tax, and Note A copy of documents requested.

Other, Yes, and or you elect to use the same of Form 763 S Virginia

Step 3: Prior to moving forward, it's a good idea to ensure that all blank fields were filled in correctly. When you determine that it's correct, click on “Done." Right after starting afree trial account at FormsPal, you'll be able to download Virginia Special Nonresident Claim For Individual Income Tax Withheld or send it through email without delay. The file will also be readily available in your personal account menu with all your adjustments. FormsPal provides safe form tools with no data recording or any kind of sharing. Rest assured that your information is secure with us!

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