2022 Virginia Schedule PY ADJS 
(Form PY ADJS) *VA0PYS122888*
Your Name Your SSN

Use Schedule PY ADJS if you are claiming more additions, subtractions or deductions than the Schedule 760PY ADJ allows.  
Use additional Schedules PY ADJS if necessary.  Refer to the instructions for Other Codes.
Additions to Adjusted Gross Income B Spouse  A You  
Filing Status 4 ONLY Include Spouse if Filing Status 2
Code 

00 00
1. ................................................................................

00 00
2. ................................................................................

00 00
3. ................................................................................

00 00
4. ................................................................................

00 00
5. ................................................................................
6. Total Fixed Date Conformity Additions.  Include the amount 
from Line 6 in total of all additions on Line 3 of Schedule 00 00
760PY ADJ. ............................................................................

Subtractions from Adjusted Gross Income B Spouse A You 
Filing Status 4 ONLY Include Spouse if Filing Status 2
Code
00 00
7. ................................................................................

00 00
8. ................................................................................

00 00
9. ................................................................................

00 00
10. ................................................................................

00 00
11. ................................................................................
12. Total Fixed Date Conformity Subtractions.  Include the 
amount from Line 12 in total of all subtractions on Line 7 of 00 00
Schedule 760PY ADJ. ............................................................

Deductions from Virginia Adjusted Gross Income B Spouse A You 
Filing Status 4 ONLY Include Spouse if Filing Status 2
 Code 
00 00
13. .............................................................................

00 00
14. .............................................................................

00 00
15. .............................................................................

00 00
16. .............................................................................

00 00
17. .............................................................................
18. Total Fixed Date Conformity Deductions.  Include the amount 
from Line 18 in total of all deductions on Line 9 of Schedule 00 00
760PY ADJ. ............................................................................
2601054  Rev. 06/22
Submit Schedule PY ADJS with Schedule 760PY ADJ