Form 37 - Rita Individual Income Tax Return Page 3
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Form 37 (2016)
SUMMARY OF NON W-2 INCOME
Note : Special Rules may apply for S- Corp. distributions.
SCHEDULE J
(For Columns 2-6, Enter City/Village/Township Where Earned)
See RITA Municipalities at
COLUM N 1
P rint the name o f each lo catio n
COLUM N 2
COLUM N 3
COLUM N 4
COLUM N 5
COLUM N 6
COLUM N 7
RESIDENT
(city/village/to wnship) where
LOCA TION 2
LOCA TION 3
LOCA TION 4
LOCA TION 5
LOCA TION 6
TOTA L
M UNICIP A LITY
inco me/lo ss was earned in the
appro priate bo xes.
1 1
1 2
1 3
1 4
1 5
1 6
P le a s e s e e P a ge s 5 - 6 o f t he
Ins t ruc t io ns .
21
22
23
24
25
26
Fro m Federal
23. SCHEDULE C A ttached
31
32
33
34
35
36
Rental Inco me/Lo ss
24. Fro m SCHEDULE E A ttached
41
42
43
44
45
46
Partnership/S-Corp/Trust Income/Loss
25. Fro m SCHEDULE E A ttached
51
52
53
54
55
56
A ll Other Taxable Inco me/Lo ss
26. A ttach Schedule(s)
FOR LINE 28 BELOW:
ADD COLUM NS 1-6,
71
ENTER ON PAGE 2,
(
)
RESIDENT M UNICIP A LITY LOSS
SECTION B, LINE 1b.
27.
CA RRY FORWA RD
61
62
63
64
65
66
CURRENT YEA R WORKP LA CE
INCOM E
28. (To tal Lines 23-27)
72
73
74
75
76
C a lc ula t e t a x due o n wo rk pla c e inc o m e :
(
) (
) (
) (
) (
)
LESS LOSS CA RRY FORWA RD
29.
82
83
84
85
86
NET TA XA B LE WORKP LA CE INCOM E
(Line 28 minus Line 29)
30.
FOR LINE 32 BELOW:
FOR EA CH R IT A M UN IC IP A LIT Y LISTED IN
ADD COLUM NS 2-6,
COLUM NS 2-6 - ENTER THE TA X RA TES.
ENTER ON PAGE 2,
N o t e : If Line 3 0 is le s s t ha n ze ro , do N O T
SECTION B, LINE 11.
e nt e r t a x ra t e .
31 .
M UNICIP A L TA X DUE to EA CH R IT A
M UN IC IP A LIT Y
N o t e : If a m o unt s in C o lum ns 2 - 6 a re $ 10
o r le s s , e nt e r - 0 - . D o N O T inc lude N O N -
R IT A M unic ipa lit ie s .
32.
Note: If you are a resident of a RITA municipality – please go to Page 4 for WORKSHEET L to allocate income/loss and calculate
potential credit for your resident municipality.
SCHEDULE K
.
To complete Schedule K, see page 6 of the instructions. If additional space is needed, use a separate sheet
33.
W-2 WAGES EARNED IN A RITA MUNICIPALITY OTHER THAN YOUR RESIDENCE MUNICIPALITY AND FROM
WHICH NO MUNICIPAL INCOME TAX WAS WITHHELD BY EMPLOYER. Complete lines below.
Tax Rate
Wages
Municipality
(see instructions)
Tax Due
Add Tax Due Column, enter total here AND on Page 2, Section B, Line 10.
33. ______________
34.
W-2 WAGES EARNED IN A NON-RITA TAXING MUNICIPALITY AND FROM WHICH NO MUNICIPAL INCOME TAX
WAS WITHHELD BY EMPLOYER. ONLY USE THIS SECTION IF YOU HAVE FILED AND PAID THE TAX DUE TO
YOUR WORKPLACE MUNICIPALITY. PROOF OF PAYMENT MAY BE REQUIRED. Complete lines below.
Tax Rate
Wages
Municipality
(see instructions)
Tax Due
Add Tax Due Column, enter total here.
34. ______________
ENTER the amount from WORKSHEET L, Row 9, Column 7.
35. ______________
Add Lines 33-35. Enter total on Page 2, Section B, Line 4b.
36. ______________
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