Maine Residency Information and Income Allocation for Nonresidents and Part-Year Residents

Residency Information and Income Allocation for Nonresidents and Part-Year Residents
2023 Worksheet A&B (Form 1040ME)
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Your Social Security Number

Name(s) as shown on Form 1040ME

Attachment
Sequence No. 10

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WORKSHEET A - Residency Information Worksheet
for Part-year Residents/Nonresidents/Safe Harbor Residents
Enclose with your Form 1040ME

The following individuals must complete Worksheet A: 1) All part-year residents whether moving into or out of Maine during the tax year; 2)
nonresidents and safe harbor residents who are filing a Maine return for the first time, and 3) former Maine residents who are filing as nonresidents
or safe harbor residents for the first time. Failure to enclose a completed Worksheet A with your 1040ME may delay processing of your return.
Yourself
Spouse
1. NAME ........................................................................................................................................... 1. ________________ ________________
a. Social security number ........................................................................................................... 1a. ________________ ________________
b. Date of birth ............................................................................................................................ 1b. ________________ ________________
c. Occupation.............................................................................................................................. 1c. ________________ ________________
Unless otherwise indicated, enter “Yes” or “No” on each line. During 2023:
2. I was domiciled in (Enter state(s)) ................................................................................................ 2. ________________ ________________
3. I was in the military and stationed in (Enter state or country) ...................................................... 3. ________________ ________________
a. My designated state of legal residence was (Enter state) ...................................................... 3a. ________________ ________________
4. The number of days I spent in Maine (for any purpose) was ....................................................... 4. ________________ ________________
5. I own(ed) a home/real property in Maine .................................................................................... 5. ________________ ________________
a. If yes, in what municipality was the property located? ............................................................ 5a. ________________ ________________
b. Did you ever apply for a Homestead or Veterans property tax exemption? ........................... 5b. ________________ ________________
c. Have you disposed of the property? ....................................................................................... 5c. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
6. I became a Maine resident on (Enter date) .................................................................................. 6. ________________ ________________
a. Enter state of prior residence.................................................................................................. 6a. ________________ ________________
b. Registered to vote in Maine .................................................................................................... 6b. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
c. Purchased a home in Maine ................................................................................................... 6c. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
d. Obtained a driver’s license in Maine ....................................................................................... 6d. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
e. Registered an auto or other vehicle in Maine ......................................................................... 6e. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
7. I moved from Maine and became a nonresident (I established a legal residence in
another state) (Enter date of move) ............................................................................................. 7. ________________ ________________
a. Enter new state of residence .................................................................................................. 7a. ________________ ________________
b. Registered to vote in my new state of residence .................................................................... 7b. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
c. Purchased a home in my new state of residence ................................................................... 7c. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
d. Obtained a driver’s license in my new state of residence....................................................... 7d. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
e. Registered an auto or other vehicle in my new state of residence ......................................... 7e. ________________ ________________
If yes, when? (Yourself:_____________________ Spouse: ____________________ )
f. If married, did your spouse and dependent children (if any) move to your new
state of residence? ................................................................................................................. 7f. ________________ ________________
8. During period of nonresidency, have you:
a. Performed any work or services in Maine............................................................................... 8a. ________________ ________________
If yes, list employer. (Yourself: ___________________ Spouse: _________________ )
b. Registered an auto or other vehicle in Maine ......................................................................... 8b. ________________ ________________
c. Renewed a Maine driver’s license .......................................................................................... 8c. ________________ ________________
d. Voted in Maine, in person or by absentee ballot ..................................................................... 8d. ________________ ________________
e. Attended or sent your children (if any) to a Maine school....................................................... 8e. ________________ ________________
f. Purchased a Maine resident hunting or fishing license .......................................................... 8f. ________________ ________________
g. Listed Maine as your legal residence for any purpose ........................................................... 8g. ________________ ________________
h. Obtained or renewed any Maine trade or professional licenses or union memberships ........ 8h. ________________ ________________
9. If you answered “yes” to question 5 but have not disposed of the property, what use do
you intend to make of it and how often (Attach a separate sheet if necessary)? _________________________________________________
_______________________________________________________________________________________________________________
10. If you answered “no” to question 7(f), please explain the circumstances (Attach a separate sheet if necessary): _______________________
_______________________________________________________________________________________________________________

Your Social Security Number

Name(s) as shown on Form 1040ME

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WORKSHEET B

Income Allocation Worksheet for Part-Year Residents/Nonresidents/Safe Harbor Residents
(See instructions at www.maine.gov/revenue/tax-return-forms) - Enclose with your Form 1040ME

Part-year residents, nonresidents and safe harbor residents must complete this worksheet before completing Schedule NR.

(Note: Married persons filing separate
Maine income tax returns must complete
separate worksheets for each spouse)

Column A
Income from
federal return

1.

Maine Resident Period
(Part-year residents only)

Federal Income

Wages, salaries, tips,
other compensation** ..........................

1

2.

Taxable interest ....................................

2

3.

Ordinary dividends ...............................

3

4.

Alimony received .................................

4

5.

Business income/loss ..........................

5

6.

Capital gain/loss ..................................

6

7.

Other gains/losses ...............................

7

Column B

Column C*

Nonresident Period
(Part-year residents, Nonresidents
and Safe Harbor residents)
Column D

Column E

Income from Column Income from Column B Income from Column Income from Column D
A for this period
earned outside of Maine
A for this period
from Maine sources

8.
9.

Taxable amount of IRA distributions .... 8
Taxable amount of pensions
and annuities ....................................... 9
10. Rental real estate, royalties,
partnerships, S corporations, and
trusts, etc ............................................. 10
11. Farm income/loss ................................ 11
12. Unemployment Compensation ............ 12
13. Taxable amount of social
security benefits ................................... 13
14. Other income (including lump-sum
distributions, but excluding state
income tax refunds) ............................. 14
15. Add lines 1 through 14 ......................... 15

*Part-year residents must make an entry in Column C if income was earned in another jurisdiction during the
period of Maine residency. Enter below the name of each other jurisdiction and the dates the income was earned in those
jurisdictions. Use a separate sheet if additional space is needed.
Name of other jurisdiction _____________________________

Period (mm/yy) From _____________ To _____________

Name of other jurisdiction _____________________________

Period (mm/yy) From _____________ To _____________

Name of other jurisdiction _____________________________

Period (mm/yy) From _____________ To _____________

You must attach a copy of the income tax return(s) filed with the other jurisdiction

**If necessary, use Worksheet C (Employee Apportionment Worksheet) for Part-Year Residents/Nonresidents/Safe
Harbor Residents to calculate the amount for line 1, Column E. For a copy of Worksheet C, go to the Maine Revenue
Services website at: www.maine.gov/revenue/tax-return-forms.
Note: See instructions at www.maine.gov/revenue/tax-return-forms on how to use Worksheet B, line 15 entries to
complete line 1 of Schedule NR.

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