Form S-1040 - Individual Return - 2012
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1
2INDIVIDUAL RETURN
SAGINAW
2012 S-1040
DUE April 30, 2013
FILING STATUS
MARRIED FILING SEPARATELY
Your First Name and Initial
Last Name
Social Security Number
SINGLE
Enter Spouse's SSN # and Full Name
Spouse's Social Security Number
If Joint, Spouse's First Name and Initial
Last Name
MARRIED FILING JOINT
NAME:
MARRIED FILING SEPARATELY
SSN#
Mailing Address
City/Town
State
Zip Code
TOTAL EXEMPTIONS
RESIDENCY STATUS
- MUST COMPLETE ADDRESS & EMPLOYER SECTION ON PAGE 2
ENTER ALL INCOME INCLUDING WAGES, TIPS, BONUSES, SICK PAY, RETIREMENT BUYOUTS, ETC, EARNED IN AND
RESIDENT
OUTSIDE THE CITY OF SAGINAW.
INCLUDE ALL INCOME AND WAGES EARNED DURING RESIDENCY AND WAGES EARNED IN THE CITY OF SAGINAW WHILE A
PART-YEAR RESIDENT
NON-RESIDENT.
IF YOU WORKED FOR AN EMPLOYER IN THE CITY OF SAGINAW ONLY, PUT TOTAL WAGES IN COLUMN SUBJECT TO TAX. IF YOU WORKED IN
NONRESIDENT
AND OUTSIDE THE CITY OF SAGINAW FOR AN EMPLOYER, GO TO PAGE 2 AND USE THE NONRESIDENT WAGE ALLOCATION.
INCOME
From Federal Return
Not Subject to Tax
Subject to Tax
1
Wages, salaries, tips, bonuses, sick pay, retirement buyouts, etc.
1
00
ATTACH
2.
Taxable Interest and Ordinary Dividends.
(RESIDENTS & PART-YEAR RESIDENTS ONLY)
2
00
COPY OF
3.
Alimony received.
3
00
(Attach copy of federal Schedule C)
4
FEDERAL
4.
Business income.
00
RETURN
(Attach copy of federal Schedule D)
5
5.
Capital gains or losses.
00
TO THE
(Attach copy of federal Form 4797)
6
6.
Other gains or losses.
00
(Attach copy of Form 1099-R)
7
BACK
7.
Taxable IRA distributions.
00
(Attach copy of From 1099-R)
OF THIS
8.
Taxable pension distributions.
8
00
(Attach copy of federal Sch. E)
9
RETURN
9.
Rental real estate, royalties, partnerships, trusts, etc.
00
10
10.
(Attach copy of federal Schedule K-1)
NOT APPLICABLE
00
Subchapter S Corp distributions/dividends
Residents Only.
(Attach copy of federal Schedule F)
11.
Farm income or (loss).
11
00
Military pay and Unemployment
NOT TAXABLE TO CITY
12
ATTACH
12.
NOT TAXABLE
NOT TAXABLE
00
W-2's
13.
Social security benefits.
NOT TAXABLE TO CITY
13
NOT TAXABLE
NOT TAXABLE
00
14
AND
14.
Other income. List type and amount.
Type
Amount $
00
15
FORMS
15.
Total income. Add lines 1 through 14.
00
DEDUCTIONS
HERE
See instructions. Deductions must be allocated on the same basis as related income.
16.
Individual Retirement Account deduction. (Attach copy of page 1 of federal return)
16
00
17.
Self Employed SEP, SIMPLE and qualified plans. (Attach copy of page 1 of federal return)
17
00
18.
Employee business expenses. (See instructions and attach copy of federal Form 2106 )
18
00
(Attach copy of federal Form 3903
19
19.
Moving expenses. (Into Taxing area only )
)
00
(Attach copy of page 1 of federal return)
20
Alimony paid. DO NOT INCLUDE CHILD SUPPORT
20
00
21
Renaissance Zone deduction. (ATTACH ORIGINAL CERTIFICATE)
21
00
Total deductions. Add lines 16 through 21
22
22
00
Total income after deductions. Subtract line 22 from line 15.
23
23
00
24
Amount for exemptions. (Number of exemptions, _____ x $750)
MUST COMPLETE EXEMPTION SCHEDULE ON PAGE 2
24
00
ATTACH
25
Total income subject to tax. Subtract line 24 from line 23
25
00
CHECK
26
Tax at
MULTIPLY LINE 25 BY
.015 (Resident)
.0075 (Non-Resident)
% (Partial Resident-from table)
26
00
PAYMENTS AND CREDITS
OR
(If line 26 exceeds $100 see instructions for making estimated tax payments)
MONEY
27
Tax withheld by your employer (ATTACH 2012 W-2 FORMS showing Saginaw Tax Withheld)
27
00
ORDER
28
Payments on 2012 Declaration of Estimated Income Tax payments with an extension and credits forward from 2011
28
00
29
00
HERE
29
Tax paid to another city and for tax paid by a partnership. (ATTACH COPY OF OTHER CITY'S RETURN)
30
Total payments and credits. Add lines 27 through 29
30
00
31
31. If tax (line 26) is larger than payments(line 30) you OWE TAX. Please enter amount due and submit payment with
TAX DUE
return. Or enter bank information for ELECTRONIC BANK WITHDRAWAL
00
32. If payment(line 30) is larger than tax (line 26) ENTER OVERPAYMENT
REFUND
33. Overpayment to be HELD and APPLIED TO 2013 estimated tax.
CREDIT FORWARD
(
)
34. DONATIONS for annual fireworks, please donate $1.00 or more
DONATION
(
)
REFUND
35. REFUND subtract line 33 & 34 from line 32, this is your total refund
00
ELECTRONIC
Pay Tax Due - Electronic funds withdrawal
36 Mark one:
Refund - Direct Deposit
REFUND OR
a. Routing number
PAYMENT
savings
b. Account number
C. Account Type:
Checking
INFORMATION
MAIL PAYMENTS TO: INCOME TAX OFFICE
MAIL REFUND & ZERO RETURNS TO: INCOME TAX OFFICE
PO BOX 5081
1315 S WASHINGTON
SAGINAW, MI 48605-5081
SAGINAW, MI 48601
Page 1
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