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2022 Virginia Unified Nonresident Individual
Form 765 Income Tax Return *VA0765122888*
Virginia Department of Taxation
P.O. Box 760 (Composite Return)
Richmond, VA 23218-0760 FISCAL or SHORT Year Filer: Beginning Date:
For Qualified Owners of a Pass‑Through Entity (PTE) Ending Date:
Check if – Legal Name of Pass-Through Entity
Change in Address Number and Street
Legal Name Change
Amended Return Address Continued FEIN
Enter Reason Code _______ City or Town, State, and ZIP Code Virginia Account Number
760C Enclosed
Part I – Participants’ Combined Income
1. Virginia income (from Part II, Line 5) ........................................................................................................................... 1. 00
2. Total additions (from Part II, Line 11, Column B) ......................................................................................................... 2. 00
3. Subtotal. Add Line 1 and Line 2................................................................................................................................... 3. 00
4. Total subtractions (from Part II, Line 17, Column B) .................................................................................................... 4. 00
5. Virginia taxable income. Subtract Line 4 from Line 3 .................................................................................................. 5. 00
6. Amount of tax ..............................................................................................................................................................6. 00
7. Estimated tax paid for 2022 taxable year ............................................................................................ 7. 00
8. Extension payment (from Form 770IP)................................................................................................ 8. 00
9. Total credits (from enclosed Schedule CR). ........................................................................................ 9. 00
10. Total payments and credits. Add Lines 7, 8, and 9 ....................................................................................................10. 00
11. If Line 6 is greater than Line 10, enter the difference and skip to Line 15. This is the income tax you owe. ................. 11. 00
12. If Line 10 is greater than Line 6, enter the difference. This is the tax overpayment amount ..................................... 12. 00
13. Amount of overpayment you want credited to next year’s estimated tax .................................................................. 13. 00
14. Subtract Line 13 from Line 12. This is the overpayment amount .............................................................................. 14. 00
15. Addition to tax, penalty, and interest
(a) Addition to tax. Enter amount from Form 760C, if applicable ................................................ 15(a). 00
(b) Penalty – See instructions. If owed, check applicable box and enter amount:
Late Filing Penalty or Extension Penalty ........................................................15(b). 00
(c) Interest – Compute on amount from Line 11 ......................................................................... 15(c). 00
(d) Add Lines 15(a)–15(c) ...........................................................................................................15(d). 00
16. If you owe tax on Line 11, add Lines 11 and 15(d) –or– If Line 14 is an overpayment and
Line 15(d) is greater than Line 14, enter the difference. This is the AMOUNT YOU OWE. Enclose payment.......... 16. 00
17. If Line 14 is greater than Line 15(d), Subtract Line 15(d) from Line 14. This is YOUR REFUND ............................. 17. 00
Complete and enclose Schedule L.
I, the undersigned owner or authorized representative of the pass-through entity declare under the penalties provided by law that this return (including any
accompanying schedules, statements, and enclosures) has been examined by me and is, to the best of my knowledge and belief, a true, correct, and complete
return, made in good faith, for the taxable year stated, pursuant to the tax laws of the Commonwealth of Virginia. I declare that the pass-through entity has
made a diligent effort to ensure that the owners who are participating in this return are qualified to do so. I further declare that the pass-through entity has in its
possession a signed statement from each owner participating in the return that grants the pass-through entity the authority to act on the owners’ behalf in the
matter of the return and that indicates the owners’ understanding and acceptance of all the terms and conditions for the filing of such a return.
I authorize the Department of Taxation to discuss this return with my preparer. If yes, check here.
Signature of Owner or Authorized Representative Title Date
Printed Name of Owner or Authorized Representative Phone Number
Individual or Firm, Signature of Preparer Phone Number Preparer’s FEIN, PTIN, or SSN Date
Address Approved Vendor Code
Va. Dept. of Taxation 2601018-W Rev. 07/22
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