Form 1040-Mj - Hudson Individual Income Tax Return - Income Tax Division
ADVERTISEMENT
1
2HU-1040
2
HUDSON INDIVIDUAL
CITY OF HUDSON
For the year
INCOME TAX RETURN
INCOME TAX DIVISION
January 1 - December 2
Or Other Taxable Year beginning
, 2
, Ending
, 2
First Name and Initial
Last Name
Your Social Security Number
DID YOU FILE A HUDSON
(If Joint Return, First Name
RETURN LAST YEAR?
Spouse's Social Security Number
and Initial of Spouse)
YES
NO
If no, explain:
Home Address (Number and Street or rural route)
Your Occupation
City, Town or Post Office and State
Zip
Spouse's Occupation
EXEMPTIONS
TOTAL
Regular
65 or over
Blind
Dependent Children, other: (List names)
IF YES, IS THE NAME(S), FILING
Yourself
EXEMPTIONS
per Federal
STATUS AND ADDRESS IDENTICAL
Return
TO PREVIOUS YEAR RETURN?
1.
Spouse
YES
NO
2. Your Filing Status -
Resident (full year)
Non-Resident (full year)
check only one:
If no, explain:
Part-Year Resident (see Schedule B)
Single
Married filing joint return
Lived in Hudson during past year
Married filing separately.
From
To
Former Address
INCOME -
TOTAL WAGES
(If joint return, include all income of both husband and wife)
REPORT DOLLARS AND CENTS
1. Enter GROSS income from employers for wages, salaries, commissions, tips, sick
REPORTED ON W-2 OR 1099
DO NOT ROUND OFF
pay etc. (DO NOT INCLUDE S.U.B. [Supplemental Unemployment Benefit] PAY)
Employer's Name
Address at Major Work Site
DOLLARS
CENTS
Should we have any questions,
please provide a phone number.
TOTALS
1.
2A.
Dividend and interest income per Federal Return: [Residents Only]
2A.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2B.
Additions to Income from page 2, PART 1, line 9
2B.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.
Total Income - [Add lines 1, 2A and 2B]
3.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4A.
Subtractions from Income from page 2, PART 2, line 4
4A.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4B.
Subtractions for IRA [Individual Retirement Account]
4B.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
Adjusted Income - [line 3 less lines 4A and 4B]
5.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
EXEMPTIONS: Multiply the number of exemptions claimed by $1,000.00
6.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
Income subject to tax - [line 5 less line 6]
7.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
TAX - Multiply amount on line 7 by one of the following:
A. RESIDENT ONLY - 1% [.01]
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. NON-RESIDENT ONLY - 1/2% [.005]
8.
(Report Dollars and Cents)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. PART-YEAR RESIDENT - Tax from Schedule B, Line 10
(Do Not Round Off)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PAYMENTS AND TAX CREDITS
MAKE CHECKS
9.
9.
PAYABLE TO
Hudson Tax Withheld [attach copy of W-2 showing city tax withheld] . . . . . . . . . . . . . . . . . . . . . .
10.
10.
TREASURER
Current year estimated payments [including credit from prior year overpayment] . . . . . . . . . . . . .
11.
11.
CITY OF HUDSON
Credits for income tax paid to another MI municipality or by a partnership . . . . . . . . . . . . . . . . . . . .
TAX DUE OR REFUND
12. Total Payments and Credits - (Add Lines 9, 10 and 11)
12.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. If line 8 is larger than line 12 enter BALANCE DUE
PAY IN FULL WITH RETURN
13.
. . . . . . . . . . . . . . . . . . . . . . . .
14. If line 12 is larger than line 8 enter OVERPAYMENT
14.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14A. Amount to be credited to next years Estimated Tax
14A.
. . . . . . . . . . . . . . . . . . . .
14B. Amount to be refunded (less than one dollar [$1.00] not refunded)
14B.
This return is due April 30th, or on the last day of the fourth month after the close of your tax year.
Under penalties of perjury, 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. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign
Your Signature
Date
Signature of preparer other than taxpayer
Date
here
Spouse's signature (if filing jointly BOTH must sign even if only one had income)
Address
Mail Return To: City of Hudson, Income Tax Division, P.O. Box 231, Hudson, Michigan 49247
PAGE 1
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