COMBINED TAX RETURN FOR INDIVIDUALS
FORM
MULTNOMAH COUNTY BUSINESS INCOME TAX
CITY OF PORTLAND BUSINESS LICENSE TAX
SP-2010
2010 Calendar year (explain if different tax year)
DUE DATE: April 18, 2011 for calendar year filers
Reset Form
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)
$0
1. Net Income or (Loss) from Federal Schedule C
_________________________ (Attach all Schedule Cs)
$0
2. Business Income Tax & Business License Tax Add Back
_________________________
$0
3. Net Income or (Loss) from Federal Schedule E, D, etc.
_________________________ (Attach Schedule E, D, etc.)
$0
4. Subtract ½ SE tax (see instructions)
_________________________
$0
5. Adjusted Net Income (total lines 1, 2, 3 and 4)
_________________________
1
6. Compensation Allowance Deduction (see instructions)
(________________________)
$0
(# of owners______)
7. Subject Net Income (line 5 minus line 6)
_________________________
$0
Multnomah County Business Income Tax
Average Sum of Multnomah Employees in 2010
$1
100.0000%
8. County Gross Income =
____________________________ =______________.______ (If not liable, push Not MC Liable button)
Total Gross Income*
$1
Not MC Liable
*If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common).
$0
9. County Apportioned Net Income (line 7 x line 8)
____________________
$0
10. Net Operating Loss Deduction (max 75% of line 9)
(___________________)
Must be entered as negative sum
$0
11. Income Subject to Tax (line 9 minus line 10)
____________________
$100
12. Tax (line 11 x tax rate of 1.45%) MINIMUM $100
____________________
13. Prepayments
(___________________)
$0
Must be entered as negative sum
$0
14. Penalty
____________________
$0
15. Interest
____________________
$100
16. Balance Due or (Overpayment)
_____________________
$0
$0
$0
17. Refund _______________ Credit _________________ Transfer to Portland ______________
City of Portland Business License Tax
Average Sum of Portland Employees in 2010
$1
100.0000%
18. Portland Gross Income = ____________________________ =______________.______ (If not liable, push Not PL Liable button)
Not PL Liable
Total Gross Income*
$1
*If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common).
$0
19. Portland Apportioned Net Income (line 7 x line 18)
____________________
20. Net Operating Loss Deduction (max 75% of line 19)
(___________________)
$0
Must be entered as negative sum
$0
21. Income Subject to Tax (line 19 minus line 20)
____________________
22. Tax (line 21 x rate of 2.2%) MINIMUM $100
____________________
$100
Must be entered as negative sum
23. Prepayments
(___________________)
$0
24. Penalty
____________________
$0
$0
25. Interest
____________________
$100
26. Balance Due or (Overpayment)
______________________
$0
$0
$0
27. Refund _______________ Credit ________________ Transfer to Multnomah _____________
Donation to “Work for Art” Program
$0
_____________________
28. Combined Amount Due with Report (total lines 16 and 26) Check # ____________
_____________________
$200
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
(Rev. 1/28/2011)