Form 1040 - Return Of Annual Net Income Of Individuals - 1913

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TO BE FILLED IN BY COLLECTOR.
TO BE FILLED IN BY INTERNAL REVENUE BUREAU.
Form 1040.
INCOME TAX.
List. No.
File No.
THE PENALTY
District of
Assessment List
FOR FAILURE TO HAVE THIS RETURN IN
THE HANDS OF THE COLLECTOR OF
Date received
Page
Line
INTERNAL REVENUE ON OR BEFORE
MARCH 1 IS $20 TO $1,000.
(SEE INSTRUCTIONS ON PAGE 4.)
UNITED STATES INTERNAL REVENUE.
RETURN OF ANNUAL NET INCOME OF INDIVIDUALS.
(As provided by Act of Congress, approved October 3, 1913.)
RETURN OF NET INCOME RECEIVED OR ACCRUED DURING THE YEAR ENDED DECEMBER 31, 191
.
(FOR THE YEAR 1913, FROM MARCH 1, TO DECEMBER 31.)
Filed by (or for)
of
(Full name of individual.)
(Street and No.)
in the City, Town, or Post Office of
State of
(Fill in pages 2 and 3 before making entries below.)
1.
G
I
(see page 2, line 12)
$
ROSS
NCOME
2.
G
D
(see page 3, line 7)
$
ENERAL
EDUCTIONS
3.
N
I
$
ET
NCOME
Deductions and exemptions allowed in computing income subject to the normal tax of 1 per cent.
4.
Dividends and net earnings received or accrued, of corpora-
tions, etc., subject to like tax. (See page 2, line 11)
$
5.
Amount of income on which the normal tax has been deducted
and withheld at the source. (See page 2, line 9, column A)
6.
Specific exemption of $3,000 or $4,000, as the case may be.
(See Instructions 3 and 19)
Total deductions and exemptions. (Items 4, 5, and 6)
$
7.
T
I
on which the normal tax of 1 per cent is to be calculated. (See Instruction 3)
AXABLE
NCOME
$
8. When the net income shown above on line 3 exceeds $20,000, the additional tax thereon must be calculated as per schedule below:
INCOME.
TAX.
1
per cent on amount over $20,000 and not exceeding $50,000
$
$
2
50,000
75,000
3
75,000
100,000
4
100,000
250,000
5
250,000
500,000
6
500,000
$
Total additional or super tax
$
Total normal tax (1 per cent of amount entered on line 7)
Total tax liability
$

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