Form Hp 1040 - Individual Income Tax Return - City Of Highland Park - 2005 Page 3

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ALLOCATION OF HIGHLAND PARK WAGES
SUPPLEMENT TO HP 1040 TAX RETURN
SCHEDULE 1NR
Use this supplement to aid in proper computation of wages earned in Highland Park (Schedule 1NR). This must be completed in order to al-
locate wages, no other form is allowed.
NAME:
SS #
PRESENT EMPLOYER:
OCCUPATION:
TAX YEAR 20
JANUARY
FEBRUARY
MARCH
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
2
3
4
5
6
7
1
2
3
4
1
2
3
4
8
9
10
11
12
13
14
5
6
7
8
9
10
11
5
6
7
8
9
10
11
15
16
17
18
19
20
21
12
13
14
15
16
17
18
12
13
14
15
16
17
18
22
23
24
25
26
27
28
19
20
21
22
23
24
25
19
20
21
22
23
24
25
29
30
31
26
27
28
26
27
28
29
30
31
APRIL
MAY
JUNE
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
1
2
3
4
5
6
1
2
3
2
3
4
5
6
7
8
7
8
9
10
11
12
13
4
5
6
7
8
9
10
9
10
11
12
13
14
15
14
15
16
17
18
19
20
11
12
13
14
15
16
17
16
17
18
19
20
21
22
21
22
23
24
25
26
27
18
19
20
21
22
23
24
23
24
25
26
27
28
29
28
29
30
31
25
26
27
28
29
30
30
JULY
AUGUST
SEPTEMBER
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
M
T
W
T
F
S
1
1
2
3
4
5
1
2
2
3
4
5
6
7
8
6
7
8
9
10
11
12
3
4
5
6
7
8
9
9
10
11
12
13
14
15
13
14
15
16
17
18
19
10
11
12
13
14
15
16
16
17
18
19
20
21
22
20
21
22
23
24
25
26
17
18
19
20
21
22
23
23
24
25
26
27
28
29
27
28
29
30
31
24
25
26
27
28
29
30
30
31
OCTOBER
NOVEMBER
DECEMBER
S
M
T
W
T
F
S
S
M
T
W
T
F
S
S
S
M
M
T
T
W
W
T
T
F
F
S
S
1
2
3
4
1
2
3
4
5
6
7
1
2
5
6
7
8
9
10
11
8
9
10
11
12
13
14
3
4
5
6
7
8
9
12
13
14
15
16
17
18
15
16
17
18
19
20
21
10
11
12
13
14
15
16
19
20
21
22
23
24
25
22
23
24
25
26
27
28
17
18
19
20
21
22
23
26
27
28
29
30
29
30
31
24
25
26
27
28
29
30
31
2006
PLEASE CIRCLE THOSE DATES WORKED OUTSIDE HIGHLAND PARK.
TOTAL DAYS CIRCLED
PLEASE NOTE: ANY DEDUCTIONS MUST BE TAKEN IN PROPORTION TO PERCENT OF INCOME REPORTED

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