Income Tax Return Form - Springfield Income Tax Division - 2009 Page 2
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1
2PLEASE ATTACH COPIES OF ALL W-2 FORMS, 1099’S, AND APPLICABLE FEDERAL SCHEDULES
ATTACH COPIES OF ALL W-2 FORMS, 1099’S, AND APPLICABLE FEDERAL SCHEDULES HERE
TAXPAYER
SPOUSE
WORKSHEET A - WAGES AND COMPENSATION (From W-2’s)
WORKSHEET A - WAGES AND COMPENSATION (From W-2’s)
Location where earned -
Total wages
Withheld for
Location where earned -
Total wages
Withheld for
List separately
(as shown on W-2 form)
Springfield
List separately
(as shown on W-2 form)
Springfield
(To Part II, Line 1)
(To Part II, Line 1)
(To Part B, Line 1)
(To Part B, Line 1)
WORKSHEET B - OTHER INCOME (From Schedules and Attachments)
WORKSHEET B - OTHER INCOME (From Schedules and Attachments)
Net Taxable Gain
Net Taxable Loss
Net Taxable Gain
Net Taxable Loss
TYPE
LOCATION
From Fed. Schedule
From Fed. Schedule
TYPE
LOCATION
From Fed. Schedule
From Fed. Schedule
Proprietorship Income
Proprietorship Income
(Schedule C)
(Schedule C)
Rental Income
Rental Income
(Schedule E)
(Schedule E)
Partnership Income
Partnership Income
(Schedule E/K-1)
(Schedule E/K-1)
Farm Income
Farm Income
(Schedule F)
(Schedule F)
Other Income
Other Income
(To Part II, Line 2)
(To Part II, Line 2)
(Part B, Line 2)
(Not Less Than -0-)
(Part B, Line 2)
(Not Less Than -0-)
Losses from schedules or businesses, including multiple partnerships, may not offset gains from other
Losses from schedules or businesses, including multiple partnerships, may not offset gains from other
Losses from schedules or businesses, including multiple partnerships, may not offset gains from
Losses from schedules or businesses, including multiple partnerships, may not offset gains from
schedules or businesses except sole proprietorships, rentals and farms in the name of the same indi-
schedules or businesses except sole proprietorships, rentals and farms in the name of the same indi-
other schedules or businesses except sole proprietorships, rentals and farms in the name of the
other schedules or businesses except sole proprietorships, rentals and farms in the name of the
vidual. Net losses may not offset personal service compensation, wages or W-2 income.
vidual. Net losses may not offset personal service compensation, wages or W-2 income.
same individual. Net losses may not offset personal service compensation, wages or W-2 income.
same individual. Net losses may not offset personal service compensation, wages or W-2 income.
Partnership losses may not offset partnership, sole proprietorship, rental or farm gains.
Partnership losses may not offset partnership, sole proprietorship, rental or farm gains.
Partnership losses may not offset partnership, sole proprietorship, rental or farm gains.
Partnership losses may not offset partnership, sole proprietorship, rental or farm gains.
Jointly owned rental property gains/losses are allocated equally among owners of record, unless
Jointly owned rental property gains/losses are allocated equally among owners of record, unless
Jointly owned rental property gains/losses are allocated equally among owners of record.
Jointly owned rental property gains/losses are allocated equally among owners of record.
otherwise indicated.
otherwise indicated.
WORKSHEET C - ADJUSTMENTS TO INCOME - Must fully explain and support
WORKSHEET C - ADJUSTMENTS TO INCOME - Must fully explain and support
WORKSHEET C - ADJUSTMENTS TO INCOME
WORKSHEET C - ADJUSTMENTS TO INCOME
with documentation and calculations. Proration of income results in proration of credit.
with documentation and calculations. Proration of income results in proration of credit.
EMPLOYEE BUSINESS EXPENSE .............................. $
EMPLOYEE BUSINESS EXPENSE .............................. $
EMPLOYEE BUSINESS EXPENSE (e)...................... $ _________________________
EMPLOYEE BUSINESS EXPENSE (e)...................... $ _________________________
*
*
(See Instructions) (To Part B, Line 3)
(See Instructions) (To Part B, Line 3)
(To Part B, Line 3)
(To Part B, Line 3)
(To Part II, Line 3)
(To Part II, Line 3)
*MUST ATTACH BOTH FEDERAL SCHEDULE A AND FORM 2106
*MUST ATTACH BOTH FEDERAL SCHEDULE A AND FORM 2106
MUST ATTACH BOTH SCHEDULE A AND 2106
MUST ATTACH BOTH SCHEDULE A AND 2106
See Instructions for deduction limitations.
See Instructions for deduction limitations.
OTHER ADJUSTMENTS .............................................. $
OTHER ADJUSTMENTS .............................................. $
OTHER ADJUSTMENTS ........................................... $ _________________________
OTHER ADJUSTMENTS ........................................... $ _________________________
(To Part B, Line 3)
(To Part B, Line 3)
(To Part B, Line 3)
(To Part II, Line 3)
(To Part B, Line 3)
(To Part II, Line 3)
Must fully explain, plus support with documentation and calculations. Proration of
Must fully explain, plus support with documentation and calculations. Proration of
income results in proration of credit.
income results in proration of credit.
WORKSHEET D - CREDIT FOR OTHER CITY TAX OR JOINT ECONOMIC
WORKSHEET D - CREDIT FOR OTHER CITY TAX OR JOINT ECONOMIC
DEVELOPMENT DISTRICT (JEDD) TAX PAID - SEE INSTRUCTIONS
DEVELOPMENT DISTRICT (JEDD) TAX PAID - SEE INSTRUCTIONS
WORKSHEET D - OTHER CITY TAX CREDIT AND JOINT ECONOMIC
WORKSHEET D - OTHER CITY TAX CREDIT AND JOINT ECONOMIC
Other City Credit Allowed: 1/2 of tax correctly paid, maximum allowable credit 1% of
Other City Credit Allowed: 1/2 of tax correctly paid, maximum allowable credit 1% of
DEVELOPMENT DISTRICT TAX CREDIT - SEE INSTRUCTIONS
DEVELOPMENT DISTRICT TAX CREDIT - SEE INSTRUCTIONS
taxable income earned in other jurisdictions.
taxable income earned in other jurisdictions.
D-1
D-1
A
B
C
D
E
A
B
C
D
E
Cities or J.E.D.D. with tax rate UP TO 2%.
Cities or J.E.D.D. with tax rate UP TO 2%.
Credit Allowed: 1/2 of tax correctly paid, max. 1% of taxable income earned in other entity.
Credit Allowed: 1/2 of tax correctly paid, max. 1% of taxable income earned in other entity.
OTHER CITY
LESSER of
OTHER CITY
LESSER of
LOCATION
TAXABLE INCOME
TAX PAID
LOCATION
TAXABLE INCOME
TAX PAID
LOCATION
TAXABLE INCOME
TAX PAID
2% of Column B
Column C or D
LOCATION
TAXABLE INCOME
TAX PAID
2% of Column B
Column C or D
TOTAL
TOTAL
X .5
X .5
ALLOWABLE CREDIT, (To Part B, Line 8)
ALLOWABLE CREDIT, (To Part B, Line 8)
D-2
D-2
Cities with tax rate GREATER than 2% (i.e. Dayton - 2.25%, Oakwood - 2.5%)
Cities with tax rate GREATER than 2% (i.e. Dayton - 2.25%, Oakwood - 2.5%)
Other City Credit Allowed: 1/2 of tax correctly paid, max. 1% of taxable income earned in other city.
Other City Credit Allowed: 1/2 of tax correctly paid, max. 1% of taxable income earned in other city.
A
B
C
D
E
A
B
C
D
E
OTHER CITY
LESSER of
OTHER CITY
LESSER of
LOCATION
TAXABLE INCOME
TAX PAID
2% of Column B
Column C or D
LOCATION
TAXABLE INCOME
TAX PAID
2% of Column B
Column C or D
TOTAL
TOTAL
TOTAL
TOTAL
X
.5
X
.5
X .5
X .5
ALLOWABLE CREDIT, (To Part B, Line 8)
ALLOWABLE CREDIT, (To Part B, Line 8)
ALLOWABLE CREDIT, (To Part II, Line 8)
ALLOWABLE CREDIT, (To Part II, Line 8)
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