Form S1040 - Individual Income Tax Return 1999 Saginaw
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3S1040 INDIVIDUAL INCOME TAX RETURN 1999 SAGINAW
DUE DATE: APRIL 30, 2000
MUST TYPE OR PRINT IN INK. INCOMPLETE FORMS WILL BE RETURNED
P
Your First Name and Initial
Last Name
Your Social Security Number
CITY USE ONLY
R
IP _____________
If Joint, Spouse’s First Name & Initial
Last Name
Spouse’s Social Security Number
I
UP _____________
Mailing Address
IF Married Filing Separately Give Spouse’s
Name_____________________________
N
AUDITOR ______
City/Town
State
Zip Code
Social Security # ____________________
T
Employers during 1999 & actual job location (If more than one
employer use Schedule J on back)
Enter name and address used on your 1998 return. If none filed please give reason.
O
Indicate the number of months that you were a Saginaw City resident in 1999______Months
RESIDENCY STATUS
EXEMPTIONS
R
MARK ONE BOX ONLY
Actual Address Where You Resided in 1999 (If additional addresses, use schedule H on back)
Yourself
65 or over
RESIDENT – City of Saginaw
T
Dependents Name
Relationship
Blind
NON-RESIDENT
Spouse
Y
65 or over
PARTIAL-Worked all year in City
P
Blind
Resident part of year
Number of Dependents
E
OTHER-Attach S1040TC or show
Listed on the left
Calculations on Schedule H
TOTAL EXEMPTIONS
INCOME
Federal
Column I
Column II
Column III
MUST ATTACH FEDERAL SCHEDULES
Form
Total Wages
EXCLUSIONS
(Col. I Less Col. II)
To support figures on Lines 3 through 9a
1040
From Page 2
SAGINAW CITY INCOME
Attach
1. Wages and Salaries
A
$
$
00
Copies
2. Interest and Dividends (RESIDENTS ONLY)
B
00
of
3. Business Income
C
00
Form
W-2
D
.
00
4
Sale or Exchange of Property (Includes 4797)
Here
00
5. Supplemental Income
E
è
6. Pension Distributions
-
7. Qualified Retirement Plan Distributions
-
8. Miscellaneous Income (Complete Schedule G on back)
-
00
Attach
9a. Adjustments (Must Attach Federal Schedules)
(
00)
Check
or
9b. Renaissance Zone Adjustment (Must Attach Original Certificate)
(
00)
Money
10. Total Income (Lines 1 thru 9b.)
$
00
Order
Here
11. Less Exemption Credit (see TOTAL EXEMPTIONS)
(No. ______ x $1,000.00)
(
00)
è
12. Taxable Income (Subtract Line 11 from Line 10) IF LINE 11 IS GREATER THAN LINE 10 ENTER “0”
00
00
13. Tax (Multiply Line 12 by ____.015(Resident) ____.0075(Non-Resident) or ______% (Partial Resident-from table)
00
PAYMENTS
14. Total Tax Withheld by Employers (Attach Forms W-2 Showing Saginaw Tax withheld from box 21 of W-2)
00
15. Payments on 1999 Declaration of Estimated Saginaw Income.
AND
00
16. Other Credits (Attach Copy of that city’s tax return)
CREDITS
16a. FIREWORKS CONTRIBUTION: $1.00 OR MORE FOR THE ANNUAL FIREWORKS
(
00)
17. TOTAL (If no entries on Lines 14, 15 or 16 must add entries on Lines 13 and 16a)
00
00
18. If Line 13 is larger than Line 17, Subtract Line 17 from Line 13. AMOUNT YOU OWE (PAY IF $1.00 OR MORE)
$
TAX DUE
OR
19. If Line 17 is larger than Line 13, Subtract Line 13 from Line 17. This is the amount you OVERPAID
$
00
REFUND
20. Amount of refund you would like applied to next year’s tax return
$
00
Allow until June 15, 2000
21. Subtract Line 20 from Line 19.
Enter Amount to be REFUNDED TO YOU
$
00
Under penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief it is true, correct and complete.
Keep a
Your
Preparer’s
copy of
Signature ________________________________________ Date_____________
Signature ___________________________ Date____________
this form
for your
Spouse’s
Preparer’s
records
Signature ________________________________________ Date_____________
Phone No. ___________________________
(IF FILING JOINTLY, BOTH MUST SIGN EVEN IF ONLY ONE HAD INCOME)
MAKE CHECKS PAYABLE TO: TREASURER, CITY OF SAGINAW AND MAIL TO:
INCOME TAX DIVISION, 1315 S. WASHINGTON AVE, SAGINAW, MI 48601
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