Computation Of Springdale Taxable Income Form - City Of Springdale

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COMPUTATION OF SPRINGDALE TAXABLE INCOME
Year:__________
Name:___________________________ Social Security #:_______________________
Employer Name and Local Address_________________________________________
Allocation of wage and salary income – City of Springdale
1.
Total days in the year
___365__
2.
Number of Non-Work days
A. Saturdays and Sundays (ONLY) ***
(Exclusive of days worked)
__________
B. Other Non-Work days
(Leave without pay ONLY) ***
__________
C. Total Non-Work Days
________
3.
Total Days worked in the year
(Line 1 less line 2C.)
________
4.
Total paid days worked outside Springdale
(Attach itinerary noting days worked outside of
the City and what city you did work in.) ***
__________
5.
Total days worked in Springdale
__________
6.
Percentage of income taxable to Springdale
(Line 5 ______divided by line 3 ______= %)
_______%
The % in line 6 should be multiplied times your gross salary.
This figure goes on line 3b of the Springdale BR tax return.
IMPORTANT: If the following attachments are not included with your return, the refund request
will be denied and returned to the taxpayer to resubmit:
1. This form, any appropriate schedules, an itinerary noting the date and cities worked
when out of the City of Springdale and copies of W-2(s).
2. A letter from your supervisor on company letter head verifying that the above
computations are correct and expense vouchers and/or reports are available for
auditor verification. Your supervisor’s name, title and phone number as well as your
Human Resource Department’s phone number should be noted in the letter.
*** 3. Employer verification of the dates taken for holidays, vacation, sick leave and paid
personal days. (Do not include these days on the itinerary as days outside of
the City or as non-work days.)
ALL REFUNDS ISSUED WILL BE REPORTED TO FEDERAL AND STATE TAXING
AUTHORITIES ON FORM 1099G AS REQUIRED BY LAW EFFECTIVE 1/1/83.

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