Cca Form 120-16-Ir - Municipal Income Tax - 2007

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2007–City Tax Form

— Due April 15, 2008

EST. TAX

PAID AS OF 11/30/07

CREDIT

4TH QUARTER

Clear Form

Individual

Joint

Extension Attached

TAXABLE INCOME

CCA FORM 120-16-IR

1. Employer’s Name

CITY

INCOME

Social Security No.

Name

–

Name of spouse if joint return

–

Current address

Apt. #

Move In

City, State, Zip

Move Out

(

)

Attach W-2’s

Total Wages

or 1099’s

Less Allowable

(

)

Attach Fed. 2106

2106 Expenses

& Schedule A

IF MOVED DURING THE YEAR SHOW CHANGES BELOW

(

Line 2 less

)

Net Taxable Wages

$0.00

Line 3

–

Attach

(

)

Business Income

Schedule C

(

Attach

)

Rental Income

Schedule E

–

Attach

(

)

K-1 Income

Move In

Schedule E & K-1

Other Income Source

Move Out

(

)

–

For

Only

Cities

Select City

$0.00

Select City

$0.00

Select City

$0.00

Select City

$0.00

Total each column. Add Positive

$0.00

Figures only in Column 8.

CREDIT

REFUND

in Column 8, enter as

Enter amount to be

Enter amount to be credited to

credit or refund.

2008 here and in Column 11

refunded here

For

Only

Select City

$0.00

Select City

$0.00

Select City

$0.00

For

Click here to go to calculation area

Only

$0.00

Total each column. Add Positive

$0.00

Figures only in Column 20.

CREDIT

REFUND

Enter amount to be

in Column 20, enter as

Enter amount to be credited

credit or refund.

refunded here

to 2008 here and in Column 23

For

Only

$0.00

Select City

$0.00

Select City

$0.00

Add Figures Shown in Last Column of Lines 10-13-15-17

$0.00

I DECLARE THAT I HAVE EXAMINED THIS RETURN AND ACCOMPANYING SCHEDULES AND STATEMENTS. TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS TRUE, CORRECT AND COMPLETE. THE FIGURES USED HEREIN ARE THE SAME AS USED FOR FEDERAL INCOME TAX PURPOSES ADJUSTED TO MUNICIPAL INCOME TAX ORDINANCES.

Signature of Taxpayer

Signature of Spouse, if Joint Return

DATE

Signature of Preparer, if not Taxpayer

DATE

SIGN

HERE

(MAKE CHECK PAYABLE TO CENTRAL COLLECTION AGENCY)