Form Br 1040p - Individual Return - City Of Big Rapids Income Tax

ATTACH A COPY OF THE FRONT OF FEDERAL 1040 FORM

BR 1040P

PART YEAR FORM

2015

INDIVIDUAL RETURN

Due Date: april 30, 2016

CitY OF Big RaPiDS inCOME taX

last name

Your Social Security number

a. First name and initial

B. RESiDEnCY

RESiDEnt

inside City limits

nOn-RESiDEnt

if Joint First name of Spouse

Spouse’s Social Security number

township of

Big Rapids

green

Present home address

Colfax

grant

Barton

norwich

home

City, State and Zip Code

Other_______________________

(Please specify)

D. EXEMPtiOnS

C. Filing StatuS

number______________________x $600.00 = $______________

a. _____ Single

D. name of Deceased:

if you are claimed as a dependent on someone else’s Big Rapids return, check

B. _____ Married, Filing Jointly

__________________________________

this box and do not take the exemption.

if you are a FSu student with per-

C. _____ Married, Filing Separately

manent home other than Big Rapids, check this box and claim yourself.

Spouse’s name__________________________________________________

Social Security number __________________________________________

Dates From:______________________

to:______________________

use this form only if you had taxable income during 2015

PORtiOn OF inCOME EaRnED in

Both as a Resident and non-Resident

all inCOME WhilE a

Big RaPiDS WhilE

Big RaPiDS RESiDEnt

a nOn-RESiDEnt

1. gROSS WagES (attach W-2)................................................................................

2. aDDitiOnS (attach Schedule(s) and Explain) ........................................................

3. SuBtRaCtiOnS (attach Schedules(s) and Explain) ..............................................

4. tOtal inCOME - BOth COluMnS (add lines 1, 2 and less 3) ..........................

5. lESS EXEMPtiOnS - Multiply number of Exemptions claimed by $600.00,

enter in Column 1 (if more than line 4, carry excess to Column 2) ........................

(if you are a student and your parents do not file a City of Big Rapids return,

check this box

and claim yourself)

6. taXaBlE inCOME - linE 4, less line 5 ................................................................

7. taX - Residential income: Multiply line 6, Column 1 by 1% (.01) ..................................................................................

8. taX - non-Residential income: Multiply line 6, Column 2 by 1/2% (.005) ....................................................................

(Please circle)

9. VOluntaRY COntRiButiOn tO Big RaPiDS COMMunitY POOl and/or COMMunitY liBRaRY

10. tOtal taX - add lines 7, 8 and 9 ............................................................................................................................

10.

PaYMEntS anD taX CREDitS

Office Use Only

Payment received

11.

11. B

......................................................................................

aPiDS

ithhElD

with Return

12.

12. 2015 E

....................................................................................

StiMatED

aYMEntS

_____________________

13.

_____________________

13. C

..............................................................

REDit FROM PREViOuS YEaR OVER PaYMEnt

_____________________

14.

14. C

) ..........

REDitS FOR

nCOME

aX PaiD tO anOthER

iChigan

uniCiPalitY

ESiDEntS

nlY

(add lines 11, 12, 13 & 14) ...................................................................................................... 15.

15. t

Otal

aYMEntS anD

REDitS

16. taX DuE (line 10 larger than line 15) .................................................................................................................................. 16.

17. PEnaltY anD intERESt (Schedule 3 of BR 1040 Return) .................................................................................................. 17.

18. BalanCE DuE (add lines 16 and 17) .................................................................................................................................. 18.

19. OVERPaYMEnt (line 15 is larger than line 10 .................................................................................................................... 19.

amount on line 19 is to be (ChECK OnE BOX OnlY)

Credited to 2016

Refunded to You

i declare, under penalty of perjury, that the information on this return and attachments is true and complete.

i authorize the City to discuss my

DO nOt discuss my

i declare, under penalty of perjury, that this return

claim and attachments with my

claim with my preparer.

is based on all information of which i have knowledge.

preparer

Filer’s Signature ______________________________________________ Date __________________