Form W-1040r - City Of Walker Resident Individual Income Tax Return - 2012
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1
2CITY OF WALKER RESIDENT INDIVIDUAL INCOME TAX RETURN
W-1040R
Due April 30, 2013
2012
Use the
Your first name & initial
Last name
Your Social Security Number--REQUIRED
WALKER
Mailing label
If joint, spouse's first name & initial
Last name
Otherwise
Spouse's Social Security Number
Please print
Home address (Number and street or rural route)
City, town or post office
State
Zip code
Day phone
Evening phone
SEE
INSTRUCTIONS
Taxpayer only
Part Year Resident from _____/_____/_____ to _____/_____/_____
If married, is spouse filing
Yes
No
Spouse only
a separate return?
Both
Former Address:
Schedule 1
Exemption Amount
1.
Check boxes that apply:
Regular
65 or over
Blind
1.
Number of boxes checked
Yourself
2.
Number of dependent children and/or other dependents for 2.
which you claimed an exemption on your federal return
Spouse
**
3.
Total number of exemptions--add lines 1 and 2
3.
**If this box is checked, you must enter spouse's social
Multiply number of exemptions in line 3 by $600
security number above and spouse must sign return
and enter on line 5 of return summary below.
Schedule 2
Wage Detail
ATTACH WALKER COPY OF FORM(S) W-2
Column A
Column B
Walker tax
Total wages from
Employer's name
Street address of actual work location(s)
withheld
Box 1 of W-2
.00
.00
.00
.00
.00
.00
.00
.00
Totals 1a.
.00 1b.
.00
Schedule 3
Payments
1.
Tax withheld by your employer from line 1a. of Schedule 2
1.
.00
2.
2012 estimated payments, credit from 2011 W-1040R, payment with extension
2.
.00
3.
Credit for tax paid to another city--from Page 2, Worksheet 1
3.
.00 Attach copy of other return
4.
Total payments--enter here and on line 8 of return summary below
4.
.00
.00
1. Total wages, salaries and tips from Schedule 2, line 1b.
Attach your W-2 form(s)
1.
.00
Return
2. Other income/loss from Page 2, Schedule 4, line 11
2.
.00
Summary
3. Deductions from Page 2, Schedule 5, Line 5 (Enter as negative amount)
3.
.00
4. Combine lines 1, 2 and 3. This is your total Walker income
4.
.00
Exemptions
5. Multiply number of exemptions from Schedule 1, line 3 by $600 and enter here
5.
.00
Taxable Income 6. Subtract line 5 from line 4. This is your taxable income
6.
.00
Tax
7. Multiply line 6 by one percent (.01) This is your Walker tax
Tax >>>
7.
.00
Payments
8. Total of Walker payments from Schedule 3, line 4
Payments >>>
8.
Tax
9. If tax (line 7) is larger than payments (line 8) enter amount you owe. MAKE CHECK
PAYABLE TO WALKER CITY TREASURER OR PAY WITH A DIRECT ELECTRONIC
Pay With
.00
Due
WITHDRAWAL (Mark pay tax due, line 14b, and complete lines 14 c,d,e & f)
9.
Return >>>
.00
Overpayment 10. If payments (line 8) are larger than tax (line 7) ENTER OVERPAYMENT
Overpayment >>>
10.
.00
Credit to 2013 11. Amount of overpayment to be held and applied to your 2013 estimated tax
Credit to 2013 >>>
11.
.00
Donation
12. Overpayment donated to Education Foundation--See page 2
Donation >>>
12.
13. Amount of overpayment to be refunded (For direct deposit, mark refund box,
Refund
.00
line 14a, and complete lines 14 c,d,e & f)
Refund >>>
13.
Direct Deposit 14. Direct deposit refund or direct withdrawal payment Mark one:
14a
Refund-direct deposit
14b
Pay tax due-direct withdrawal
or
c. Routing number
e. Type of account:
Checking
Savings
(Default is date processed)
f.
Direct Payment
d. Account number
Withdrawal date:
I have read this return. Under the penalties of perjury, I declare that to the best of my knowledge and belief the return is true, correct and accurately lists all amounts and sources
of Walker income I received during the tax year. If prepared by a person other than the taxpayer, his/her declaration is based on all information of which he/she has any knowledge.
Your signature
Spouse's signature if joint return
Paid preparer's signature
PLEASE
SIGN HERE
Date
Your occupation
Date
Spouse's occupation
Address
YOU MUST ATTACH A COPY OF PAGE ONE OF YOUR 2012 FEDERAL 1040
Mail return to: City of Walker Income Tax Dept., PO Box 153, Grand Rapids, MI 49501-0153
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