Danville Income Tax Return Form - Ncome Tax Department Page 2

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(Enter on Line 3a, Page 1
SECTION D
PROFIT OR LOSS FROM BUSINESS OR PROFESSION
Business Name________________________________________________ Owner's or Partner's Name ____________________________________________
Date Business Commences _________________________________________________________________________________________________________
Business Address _________________________________________________________________________________________________________________
1.
TOTAL RECEIPTS ...................................................................................................................................................... 1. $ ____________
2.
LESS Cost of Labor $____________ Material, supplies and other costs 2. $ _____________________________
3.
GROSS PROFIT FROM SALES, ETC., (line 1 less line 2) ........................................................................................ 3. $ ____________
4.
INTEREST $____________________ OTHER BUSINESS INCOME (Specify) 4. $__________________............. 4. $ ____________
5.
TOTAL BUSINESS INCOME BEFORE DEDUCTIONS................................................................................................................. 5. $ ___________
BUSINESS DEDUCTIONS
6.
ADVERTISING AND PROMOTION..................
6. $ ______________
11. DEPRECIATION, AMORTIZATION ..... 11. $ _____________
7.
AUTO TRUCK AND TRAVEL ...........................
7. $ ______________
12. RENTS (Paid to _______________)... 12. $ _____________
8.
INT. ON BUSINESS INDEBTEDNESS ............
8. $ ______________
13. OTHER (List if over 10% of Line 14)... 13. $ _____________
9a. TAXES BASED ON INCOME........................... 9a. $ ______________
14. TOTAL BUSINESS DEDUCTIONS (Total of lines 6 to 13) 14. $ ______________
9b. OTHER BUSINESS TAXES ............................. 9b. $ ______________
15. NET PROFIT (OR LOSS) FROM BUSINESS
10. SALARIES AND WAGES ................................. 10. $ ______________
OR PROFESSION (LINE 5 LESS LINE 14) ..................... 15. $ ______________
(Enter on Line 3a (1), Page 1
SECTION E
RECONCILIATION WITH FEDERAL TAX RETURN
ITEMS NOT TAXABLE
DEDUCT
ITEMS NOT DEDUCTIBLE
ADD
a.
Capital Losses (Excluding Ordinary Losses).......... $ ______________
n.
Capital gains (Excluding Ordinary Gains) ............................... $ ______________
b.
Expenses incurred in the production of non-taxable
o.
Interest income........................................................................ $ ______________
income (at least 5% of Line r.)................................ $ ______________
p.
Dividends................................................................................. $ ______________
c.
Taxes based on income "STATE"............................ $ ______________
d.
Taxes based on income "CITY" .............................. $ ______________
q.
Other (Explain) ........................................................................ $ ______________
e.
Net operation loss deduction per Federal Return... $ ______________
................................................................................................
f.
Payments to partners.............................................. $ ______________
................................................................................................
g.
Contributions........................................................... $ ______________
h.
Other expenses not deductible (Explain)................ $ ______________
r.
......................................................................................TOTAL $ ______________
m.
TOTAL $ ______________
s.
Enter difference between Line m and r on Line 3a(1) ............ $ ______________
(Enter on Line 3a (2), Page 1
SECTION F
BUSINESS ALLOCATION FORMULA
a. LOCATED
b. LOCATED IN
c. PERCENTAGE
EVERYWHERE
Danville
(b + a)
STEP 1. AVG. VALUE OF REL & TANG. PERSONAL PROPERTY
_________________
_________________
GROSS ANNUAL RENTALS PAID MULTIPLIED BY 8
_________________
_________________
TOTAL STEP 1.
_________________
_________________
_________________
STEP 2. GROSS RECEIPTS FROM SALES MADE AND/OR WORK
OR SERVICES PERFORMED.
STEP 3. WAGES, SALARIES AND OTHER COMPENSATION PAID
_________________
_________________
_________________
STEP
4. TOTAL PERCENTAGES
_________________
_________________
_________________
STEP
5. AVERAGE PERCENTAGE (Divide Total Percentages by Number of Percentages Used).
_________________
SECTION G
RENTAL INCOME (Enter on Line 3b, Page 1)
Date
2. Amount Received
3. Depreciation or
5. Other
1. Kind of Property
Location of Property
4. Repairs
ACQUIRED
during year
deletion
Expenses
$
$
$
$
Total Net Rental Profit (or loss) (Column 2, less sum of Columns 3, 4 and 5
NET INCOME SECTION G ..................................... $ _______________
SECTION H
OTHER INCOME
Note: Distributive Share Income (whether distributed or not) of resident and non-resident
partnerships should be indicated and included as income on Page 1. Enter all other income on Line 3c, Page 1.
RECEIVED FROM
FOR (DESCRIBE)
AMOUNT
SECTION I
CALCULATION FORMULA FOR PARTIAL-YEAR INCOME
(Enter on Line 1b (1), Page 1
______________ Days worked out of the city.
SALARY_________________
Days unemployed, if applicable __________________ (1)
TAX WITHHELD_________________
260 Total days worked annually, less (1)_______________________________________________________________ - (2) Days Actually Worked_________________
$ __________________________ ÷ (2) ____________________________ - (3) $____________________________ average rage per day worked
(2) __________________________ less __________________________ days worked out - (4) __________________________ days worked in Danville.
(4) _____________________________ x (3) $ _____________________________ - (5) _____________________________ taxable wages for Danville.
(5) $_________________________ x 1% - (6) $__________________________ tax due.
$ ________________________________ withheld less (6) $________________________________ = Refund due $ _____________________________

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