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                                                                                                2022
                               DELAWARE                                                         FORM
                               DIVISION OF REVENUE                                                   PIT-NON
                               DELAWARE INDIVIDUAL NON-RESIDENT INCOME TAX RETURN
                                                                     
                                    For Fiscal Year beginning                 and ending                                                       Amended Return
                                                                                                                                               Must include page 3
Your Taxpayer ID                               Spouse Taxpayer ID                                               Filing Status (Must       check one)
                                                                                                     1.   Single, Divorced, Widow(er)    3.    Married & Filing Separate Forms

Your First Name                       M.I.     Last Name            Suffix    Form PIT-UND           2.   Joint                          5.    Head of Household

Spouse First Name                     M.I.     Last Name            Suffix            Attached
                                                                                                     If you were a part-year resident in 2022, give the dates you 
Present Home Address (Number and Street)                      Apartment #             Check if                       resided in Delaware:
                                                                              FULL-YEAR
                                                                              Non-Resident 
City                                              State  Zip Code                     in 2022             mm-dd-yyyy                           mm-dd-yyyy

                                                                                                                FEDERAL                        DELAWARE SOURCE 
                                                                                                                                               INCOME/LOSS
     SECTION A -  INCOME AND ADJUSTMENTS FROM FEDERAL RETURN                                              COLUMN A                             COLUMN B
1.   WAGES, SALARIES, TIPS, ETC.                                                                     1.                               .00 1.                      .00
2.   INTEREST                                                                                        2.                               .00 2.                      .00
3.   DIVIDENDS                                                                                       3.                               .00 3.                      .00
4.   STATE REFUNDS, CREDITS OR OFFSETS OF STATE & LOCAL INCOME TAXES                                 4.                               .00 4.                      .00
5.   ALIMONY RECEIVED                                                                                5.                               .00 5.                      .00
6.   BUSINESS INCOME OR (LOSS) (See instructions)                                                    6.                               .00 6.                      .00
7a.  CAPITAL GAIN OR (LOSS)                                                                          7a.                              .00 7a.                     .00
7b.  OTHER GAINS OR (LOSSES)                                                                         7b.                              .00 7b.                     .00
8.   IRA DISTRIBUTIONS                                                                               8.                               .00 8.                      .00
9.   TAXABLE PENSIONS AND ANNUITIES                                                                  9.                               .00 9.                      .00
10.  RENTS, ROYALTIES, PARTNERSHIPS, S CORPS, ESTATES, TRUSTS, ETC.                                  10.                              .00 10.                     .00
11.  FARM INCOME OR (LOSS)                                                                           11.                              .00 11.                     .00
12.  UNEMPLOYMENT COMPENSATION (INSURANCE)                                                           12.                              .00 12.                     .00
13.  TAXABLE SOCIAL SECURITY BENEFITS                                                                13.                              .00 13.                     .00
14.  OTHER INCOME (State nature and source)                                                          14.                              .00 14.                     .00
15.  TOTAL INCOME - Add Line 1 through Line 14                                                       15.                              .00 15.                     .00
16.  TOTAL FEDERAL ADJUSTMENTS (See instructions)                                                    16.                              .00 16.                     .00
17.  FEDERAL ADJUSTED GROSS INCOME FOR DELAWARE PURPOSES Subtract Line 16 from Line 15               17.                              .00 17.                     .00
     SECTION B -  ADDITIONS
18.  INTEREST RECEIVED ON OBLIGATIONS OF ANY STATE OTHER THAN DELAWARE                               18.                              .00 18.                     .00
19.  FIDUCIARY ADJUSTMENT, OIL DEPLETION                                                             19.                              .00 19.                     .00
20.  TOTAL - Add Line 18 to Line 19                                                                  20.                              .00 20.                     .00
21   Add Line 17 to Line 20                                                                          21.                              .00 21.                     .00
     SECTION C - SUBTRACTIONS
22.  INTEREST RECEIVED ON U.S. OBLIGATIONS                                                           22.                              .00 22.                     .00
23.  PENSION/RETIREMENT EXCLUSIONS (For a definition of eligible income, see instructions)           23.                              .00 23.                     .00
24.  DELAWARE STATE TAX REFUND                                                                       24.                              .00 24.                     .00
25.  Fiduciary Adjustment, Work Opportunity Credit, Delaware NOL Carryforward, etc.                  25.                              .00 25.                     .00
26a. Taxable Social Security Benefits/Railroad Retirement Benefits/Higher Education Exclusion        26a.                             .00 26a.                    .00
26b. 529 Contribution to Delaware-sponsored Tuition Program or ABLE Program                          26b.                             .00 26b.                    .00
27.  TOTAL Add Line 22 through Line 26b                                                              27.                              .00 27.                     .00
28.  Subtract Line 27 from Line 21                                                                   28.                              .00 28.                     .00
29.  EXCLUSION FOR CERTAIN PERSONS 60 AND OVER OR DISABLED (See instructions)                        29.                              .00 29.                     .00
30a. COLUMN B- Subtract Line 29 from Line 28.  This is your modified Delaware Source Income.          Enter on Page 2, Line 42, Box A     30a.                    .00
30b. COLUMN A - Subtract Line 29 from Line 28.  
     This is your Delaware Adjusted Gross Income.        Enter on Page 2, Line 37 and Line 42, Box B 30b.                             .00
                  BALANCE DUE WITH 
           PAYMENT ENCLOSED (LINE 59)                             REFUND (LINE 60)                              ALL OTHER RETURNS 
             MAIL COMPLETED FORM TO:                          MAIL COMPLETED FORM TO:                     MAIL COMPLETED FORM TO:
                 Delaware Division of Revenue                     Delaware Division of Revenue                  Delaware Division of Revenue    
        PO Box 508, Wilmington, DE 19899-0508                               PO Box 8710                                                     PO Box 8711 
                       Make check payable to:                     Wilmington, DE 19899-8710                          Wilmington, DE 19899-8711
                 Delaware Division of Revenue
           DFPITNON2022019999V1
           Revision 20221209                                        Page  1

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2022
DELAWARE FORM
DIVISION OF REVENUE PIT-NON
DELAWARE INDIVIDUAL NON-RESIDENT INCOME TAX RETURN

SECTION D - DEDUCTIONS
31. ENTER TOTAL ITEMIZED DEDUCTIONS (If Filing Status 3, See instructions) 31. .00
32. ENTER FOREIGN TAXES PAID (See instructions) 32. .00
33. ENTER CHARITABLE MILEAGE DEDUCTION (See instructions) 33. .00
34. TOTAL - Add Line 31 through Line 33 34. .00
35. ENTER FORM PIT-CRS TAX CREDIT ADJUSTMENT (See instructions) 35. .00
36. Subtract Line 35 from Line 34. Enter here and on Line 38. 36. .00
SECTION E - CALCULATIONS
37. DELAWARE ADJUSTED GROSS INCOME - Enter amount from Line 30b here 37. .00
38. If you elect the STANDARD DEDUCTION check here a. Filing Statuses 1, 3, & 5 enter $3250; Filing Status 2 enter $6500;
If you elect the DELAWARE ITEMIZED DEDUCTIONS check here b. Enter amount from Line 36. 38. .00
39. ADDITIONAL STANDARD DEDUCTIONS (Not Allowed with Itemized Deductions - See instructions)
Check Box(es)- if SPOUSE was: 65 or over blind Check box(es) - if YOU were: 65 or over blind 39. .00
40. TOTAL DEDUCTIONS - Add Line 38 to Line 39 and enter here 40. .00
41. TAXABLE INCOME - Subtract Line 40 from Line 37, and compute tax on this amount 41. .00
42. TAX LIABILITY COMPUTATION (See instructions) PRORATION DECIMAL Tax Liability from Tax Rate Table/
A. Line 30a .00 (See instructions) Schedule Amount
B. Line 30b .00 = X .00 42. .00
43a. PERSONAL CREDITS If you are Filing Status 3, see instructions. Enter number of exemptions listed on Federal return x $110 =
Multiply this amount by the proration decimal on Line 42 ( x ) and enter total here 43a. .00
43b. CHECK BOX(ES) SPOUSE 60 or over (if filing status 2) SELF 60 or over Enter number of boxes checked on Line 43b x $110 =
Multiply this amount by the proration decimal on Line 42 ( x ) and enter total here 43b. .00
44. TAX IMPOSED BY STATE OF Must attach copy of PIT-NNS and other state return - Part-Year Residents Only (See instructions) 44. .00
45. OTHER NON-REFUNDABLE CREDITS (See instructions) 45. .00
46. TOTAL NON-REFUNDABLE CREDITS - Add Line 43a through Line 45 46. .00
47. BALANCE - Subtract Line 46 from Line 42. If Line 46 is greater than Line 42, enter 0. 47. .00
48. DELAWARE TAX WITHHELD - (Attach W-2s/1099s) 48. .00
49. ESTIMATED TAX PAID & PAYMENTS WITH EXTENSIONS 49. .00
50. S CORP PAYMENTS (See instructions) 50. .00
51. REFUNDABLE BUSINESS CREDITS (See instructions) 51. .00
52. CAPITAL GAINS TAX PAYMENTS (Attach form REW-EST) 52. .00
53. TOTAL REFUNDABLE CREDITS - Add Line 48 through Line 52 53. .00
54. BALANCE DUE If Line 47 is greater than Line 53, Subtract Line 53 from Line 47 and enter here. 54. .00
55. OVERPAYMENT If Line 53 is greater than Line 47, Subtract Line 47 from Line 53 and enter here. 55. .00
56. CONTRIBUTIONS TO SPECIAL FUNDS (If electing a contribution, complete and attach PIT-NNS) TOTAL 56. .00
57. AMOUNT OF LINE 55 TO BE APPLIED TO 2023 ESTIMATED TAX ACCOUNT ENTER 57. .00
58. PENALTIES AND INTEREST DUE (If Line 54 is greater than $800, see estimated tax instructions) ENTER 58. .00
59. NET BALANCE DUE - Add Line 54, Line 56, and Line 58 PAY IN FULL 59. .00
60. NET REFUND - Subtract Lines 56, 57, and 58 from Line 55 ZERO DUE/TO BE REFUNDED 60. .00
SECTION F - DIRECT DEPOSIT INFORMATION If you would like your refund deposited directly to your checking or savings account, complete below. See instructions for details.
ACCOUNT TYPE Is this refund going to or
ROUTING NUMBER ACCOUNT NUMBER
CHECKING through an account that is
located outside of the United
SAVINGS States?
YES NO
PLEASE REMEMBER TO ATTACH APPROPRIATE SUPPORTING SCHEDULES WHEN FILING YOUR RETURN
BE SURE TO SIGN YOUR RETURN BELOW AND KEEP A COPY FOR YOUR RECORDS
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and PAID PREPARER INFORMATION
believe it is true, correct and complete.

YOUR SIGNATURE DATE PAID PREPARER SIGNATURE DATE
ADDRESS
SPOUSE SIGNATURE DATE CITY STATE ZIP CODE
HOME PHONE NUMBER BUSINESS PHONE NUMBER
EIN, SSN or PTIN PHONE NO.
EMAIL ADDRESS EMAIL ADDRESS

DFPITNON2022029999V1
Revision 20221209 Page 2

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                                                                                                                                         2022
                         DELAWARE                                                                                                        FORM
                               DIVISION OF REVENUE                                                                                       PIT-NON
                               DELAWARE INDIVIDUAL NON-RESIDENT INCOME TAX RETURN
                                                                                                            
FOR AMENDED RETURNS ONLY                                                                                                                                             COLUMN B
61. TOTAL REFUNDABLE CREDITS - From Line 53                                                                                                                      61.            .00
62. AMOUNT PAID ON ORIGINAL RETURN                                                                                                                               62.            .00
63. SUBTOTAL - Add Lines 61 and 62                                                                                                                               63.            .00
64. REFUND RECEIVED  (If any, see instructions)                                                                                                                  64.            .00
65. Estimated tax carryover and/or Special Funds contributions as shown on original return                                                                       65.            .00
66. Subtract Line 64 and Line 65 from Line 63                                                                                                                    66.            .00
67. BALANCE DUE - If Line 47 is greater than Line 66, Subtract Line 66 from Line 47 and enter here                                                               67.            .00
68. OVERPAYMENT - If Line 66 is greater than Line 47, Subtract Line 47 from Line 66 and enter here                                                               68.            .00
69. AMOUNT OF LINE 68 TO BE APPLIED TO YOUR ESTIMATED TAX ACCOUNT (See Instructions)                                                                             69.            .00
70. PENALTIES AND INTEREST DUE                                                                                                                                   70.            .00
71. NET BALANCE DUE - Add Line 67 and Line 69 to Line 70                                                                                 PAY IN FULL             71.            .00
72. NET REFUND - Subtract Line 69 and Line 70 from Line 68                                                                               ZERO DUE/TO BE REFUNDED 72.            .00

73. Is an amended  Federal return being filed?                                                                                                                   Yes No
    If no, please explain. If the changes pertain to the Delaware return only, list the line numbers being amended.

74. Has the Delaware Division of Revenue advised you your original return is being audited?                                                                      Yes No
75. Is this amended return being filed as a protective claim?                                                                                                    Yes No
    A detailed explanation of all changes must be provided in this space. All supporting schedules and/or documentation must be attached.

    NET BALANCE DUE WITH 
    PAYMENT ENCLOSED (LINE 71)                                                                             NET REFUND (LINE 72)                 ALL OTHER RETURNS 
    MAIL COMPLETED FORM TO:                                                                                MAIL COMPLETED FORM TO:       MAIL COMPLETED FORM TO:
    Delaware Division of Revenue                                                                           Delaware Division of Revenue         Delaware Division of Revenue  
    PO Box 508, Wilmington, DE 19899-0508                                                                   PO Box 8710                                              PO Box 8711
    Make check payable to: Delaware Division of RevenueMake check payable to: Delaware Division of Revenue Wilmington, DE 19899-8710            Wilmington, DE 19899-8711
                                    PLEASE REMEMBER TO ATTACH APPROPRIATE SUPPORTING SCHEDULES WHEN FILING YOUR RETURN
    DFPITNON2022039999V1
    Revision 20221209                                                                                      Page  3

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