Form Sp-2009 Draft - Combined Tax Return For Individuals
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1
2COMBINED TAX RETURN FOR INDIVIDUALS
FORM
MULTNOMAH COUNTY BUSINESS INCOME TAX
CITY OF PORTLAND BUSINESS LICENSE TAX
SP-2009
Taxable Year _1_/_1_/_2009_ to _12_/_31_/_2009_
DUE DATE: April 15, 2010
(Attach explanation if not a calendar year filer)
Name/Mailing
Address:
Account #:
Amended Return?
Ceased Portland/Multnomah Business?
(attach explanation)
Social Security #_______________________ and FEIN # _______________________
b
Please
if address change:
Federal Business Code ______________
Please notify Bureau if your business location changes
Attach page 1 of federal Form 1040
SOLE PROPRIETORSHIP
, 1 MEMBER LLC
, JT. VENT./TENANT-IN-COMMON
(Check all that apply)
1. Net Income or (Loss) from Federal Schedule C
_________________________ (Attach all Schedule Cs)
2. Business Income Tax & Business License Tax Add Back
_________________________
3. Net Income or (Loss) from Federal Schedule E, D, etc.
_________________________ (Attach Schedule E, D, etc.)
4. Subtract ½ SE tax (see instructions)
_________________________
5. Adjusted Net Income (total lines 1, 2, 3 and 4)
_________________________
6. Compensation Allowance Deduction (see instructions)
(________________________)
(# of owners______)
7. Subject Net Income (line 5 minus line 6)
_________________________
Multnomah County Business Income Tax
Average Sum of Multnomah Employees in 2009
8. County Gross Income =
____________________________ =______________.______
Total Gross Income*
*If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common).
9. County Apportioned Net Income (line 7 x line 8)
____________________
10. Net Operating Loss Deduction (max 75% of line 9)
(___________________)
11. Income Subject to Tax (line 9 minus line 10)
____________________
12. Tax (line 11 x tax rate of 1.45%) MINIMUM $100
____________________
13. Prepayments
(___________________)
14. Penalty
____________________
15. Interest
____________________
16. Balance Due or (Overpayment)
_____________________
17. Refund _______________ Credit _________________ Transfer to Portland ______________
City of Portland Business License Tax
Average Sum of Portland Employees in 2009
18. Portland Gross Income = ____________________________ =______________.______
Total Gross Income*
*If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common).
19. Portland Apportioned Net Income (line 7 x line 18)
____________________
20. Net Operating Loss Deduction (max 75% of line 19)
(___________________)
21. Income Subject to Tax (line 19 minus line 20)
____________________
22. Tax (line 21 x rate of 2.2%) MINIMUM $100
____________________
23. Prepayments
(___________________)
24. Penalty
____________________
25. Interest
____________________
26. Balance Due or (Overpayment)
______________________
27. Refund _______________ Credit ________________ Transfer to Multnomah _____________
Donation to “Work for Art” Program
_____________________
28. Combined Amount Due with Report (total lines 16 and 26) Check # ____________
_____________________
Make check payable to City of Portland, 111 SW Columbia St., Suite #600, Portland, OR 97201-5840.
The undersigned declares that the information given on this report is true. The undersigned is authorized to act as a representative of the filer. Filers of incomplete
returns (including returns that have not reported the Average Sum of Employees) may be subject to civil penalties of up to $500.
Signature of Filer _______________________________________________________ Filer’s Daytime Telephone (
)___________________
Signature of Preparer _______________________________________________________ Date _________________________________________
Preparer’s Name/Address ___________________________________________________ Telephone (
) _______________________________
REVENUE BUREAU (503) 823-5157
FAX (503) 823-5192
TDD (503) 823-6868
DRAFT (Rev. 11/9/2009)
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