Income Tax Return Mandatory Filing Form - City Of Brooklyn - 2004 Page 2
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1
2Attach W-2s, taxable 1099s and copies of applicable federal forms and schedules here
Copy for State, City or Local Tax Department
50,000.00
5,000.00
55,000.00
3,410.00
55,000.00
797.50
55,000.00
1,750.00
55,000.00
1,100.00
BROOKLYN
Use Box 5 for gross wages on W-2.
(Box 19)
The arrow indicates the box in which local income
tax withheld will be located on your W-2.
WORKSHEET TABLE
Number of W-2 and 1099 Misc. forms attached: ________________
COLUMN 1
COLUMN 2
COLUMN 3
Date wages were
Tax Paid to
earned (Month/Day)
Gross Income
Other Localities
Locality Where
(Box 5
Brooklyn Tax
(not to exceed
From
To
Print Employer’s Name
Employed
on W-2)
Withheld
2% of gross income)
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
___/___
TOTALS: $
$
$
(to page 1 line 1)
(to page 1 line 10)
(to page 1 line 11)
DEDUCTIONS
29. Brooklyn wages and salaries earned while under the age of 18
29
(please provide proof of age)
30. Non-resident deductions
30
(please provide calculations)
31. Employment expense
31
(attach Form 2106 and Schedule A)
32. Total deductions
Enter here and on line 5 on front of return
32
(add lines 29, 30 and 31)
PENALTY AND INTEREST
33. Penalty: Failure to file a tax return by April 15, 2005
33
($25.00)
34. Penalty: On unpaid taxes by due date
34
35. Interest:
35
36. Total penalty and interest: Add lines 33, 34 and 35
36
(enter here and on line 20 on front of return)
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