Form J1040 - Income Tax Individual Return - City Of Jackson - 2005
ADVERTISEMENT
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J J 1 1 0 0 4 4 0 0
C C H H E E C C K K
R R E E S S I I D D E E N N T T
2 2 0 0 0 0 5 5
C C I I T T Y Y O O F F J J A A C C K K S S O O N N , , M M I I I I N N C C O O M M E E T T A A X X
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F F O O R R C C A A L L E E N N D D A A R R
O O N N E E
N N O O N N R R E E S S I I D D E E N N T T
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O O R R F F I I S S C C A A L L Y Y E E A A R R E E N N D D I I N N G G
B B O O X X
P P A A R R T T - - Y Y E E A A R R
I I N N D D I I V V I I D D U U A A L L R R E E T T U U R R N N
DATE(S) OF BIRTH
FILING STATUS:
Y Y O O U U R R S S O O C C I I A A L L S S E E C C U U R R I I T T Y Y N N U U M M B B E E R R
S S P P O O U U S S E E ' ' S S S S O O C C I I A A L L S S E E C C U U R R I I T T Y Y N N U U M M B B E E R R
RESIDENT FROM _____ TO _____
FIRST NAME(S) AND INITIAL(S)
LAST NAME
TELEPHONE
SINGLE
JOINT
HOME (
)
WORK (
)
(STREET OR RURAL ROUTE) DO NOT USE P.O. BOX
Your Occupation
EMPLOYERS NAME & LOCAL ADDRESS
_____________________________
CITY, TOWN OR POST OFFICE
STATE
POSTAL ZIP CODE
Spouse's Occupation
_____________________________
EXEMPTIONS:
a. □ YOURSELF
□ 65 & Over
□ SPOUSE
□ 65 & Over
Children are allowed their
b. □ Blind
□ Paraplegic
□ Blind
□ Paraplegic
own exemption even if being
claimed on parents return:
NO. OF BOXES
Check
No. of
Dependents
If age 2 or over dependent's
CHECKED ON a
if under
Relationship
months
social security number
Name (first, initial, and last name)
Did you file a 2004 City
c.
AND b
age 2
in your home
Return? . . . . . . . . . . . .
:
:
NO. OF OTHER
DEPENDENTS
□
□
:
:
Yes
No
LISTED ON c
:
:
If yes, are the Name(s)
TOTAL EXEMPTIONS
and Address the same?
:
:
ADD NUMBERS
ENTERED ON
:
:
□
□
Yes
No
BOXES ABOVE
:
:
If no, list name and
DO NOT ROUND
address used on previous
DROP CENTS
return: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1A. TOTAL INCOME:
(all W2's Schedules and / or documents to substantiate totals must be attached in order to process return)
1A.
00
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
RESIDENTS: enter total
gross income
for 2005.
1B.
00
1B.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NONRESIDENTS: enter gross wages from W-2, or Schedule 1, page 2
(If you have no additions or subtractions, carry this amount to line 4)
2.
00
2. ADDITIONS TO INCOME:
. .
(from page 2 Schedule 2R line C for Residents or 2NR line E for Non-Residents) 1120-S income is not taxable on individual return.
I
3.
00
3. SUBTRACTIONS FROM INCOME
(From page 2 schedule 2R line M for Residents/Schedule 2NR line
for Non-Residents) 1120-S loss not deductible on individual return.
A A T T T T A A C C H H A A L L L L S S C C H H E E D D U U L L E E S S A A N N D D E E X X P P L L A A N N A A T T I I O O N N S S
4.
00
4. ADJUSTED INCOME (Add lines 1 and 2 less line 3.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
00
5. EXEMPTIONS: Multiply the number of exemptions claimed by $600.00. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
00
6. TAXABLE INCOME (line 4 less line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. TAX - Multiply amount on line 6 by one of the following:
A. RESIDENT ONLY - 1% (.01) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
00
1
B. NONRESIDENT ONLY -
/
% (.005). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
C. PART-YEAR RESIDENT - Tax from Schedule 4, line M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PAYMENTS AND TAX CREDITS:
8.
00
8. Jackson tax withheld (You must attach copies of all W2’s to obtain credit for withholding.)
9.
00
9. 2005 Estimate payments (including carry forward credit from 2004 J-1040 . . . . . . . . . . .
10.
00
10. Credits for income tax paid to another Michigan municipality (Residents Only) or by
a partnership. *Attach copy of other municipalities return.
11.
00
11. TOTAL PAYMENTS AND CREDITS (Add lines 8, 9 and 10.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Make checks payable to City Treasurer.)
12.
00
P P A A Y Y W W I I T T H H R R E E T T U U R R N N
12. BALANCE DUE: (line 7 larger than line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(No payment necessary if less than $1.00)
13. A. REFUND: (line 11 larger than 7.)
13A..
00
REFUND
. . . . . refunds will not be made for less than $1.00. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13B.
00
CREDIT
13. B. Credit to 2006 Estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14.
00
14. Interest and penalty,
will be assessed, after April 30th
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15.
00
15. TOTAL AMOUNT DUE add lines 12 & 14 (Do not enter refunds) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct
and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN HERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SIGN
(Taxpayer's signature and date)
(Signature of preparer other than taxpayer and date)
HERE
SIGN HERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Spouse's signature and date)
(Address)
(Telephone)
MAKE CHECKS PAYABLE TO: TREASURER, CITY OF JACKSON
MAIL RETURNS TO: CITY INCOME TAX DIVISION, 161 W. MICHIGAN AVE., JACKSON, MI 49201
Page 1
DUE ON OR BEFORE APRIL 30TH.
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