Form 5120 - City Of Detroit Part Year Resident Income Tax Return - 2016
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Michigan Department of Treasury - City Tax Administration
5120 (04-16)
2016 City of Detroit Part-Year Resident Income Tax Return
Check here if you are
amending. List reason on
Issued under authority of Public Act 284 of 1964, as amended.
page 3.
Return is due April 18, 2017.
1 4
Type or print in blue or black ink. Print numbers like this:
0123456789
- NOT like this:
1. Filer’s First Name
M.I.
Last Name
2. Filer’s Full Social Security No. (Example: 123-45-6789)
If a Joint Return, Spouse’s First Name
M.I.
Last Name
3. Spouse’s Full Social Security No. (Example: 123-45-6789)
Home Address (Number, Street, or P.O. Box)
City or Town
State
ZIP Code
4. CITY RESIDENT. Return for the city of:
City Code
DETROIT
170
5. 2016 FILING STATUS. Check one.
8. EXEMPTIONS. 8a-8c apply to you and your spouse only.
a.
Single
* If you check box “c,” complete
line 3 and enter spouse’s full name
Personal Exemption ......................................
a.
below:
b.
Married filing jointly
65 and over.....................................................
b.
c.
Married filing separately*
Deaf, Disabled or Blind ...................................
c.
6.
PART-YEAR RESIDENCY PERIOD. Enter dates of residency in 2016.
(Enter dates as MM-DD-YYYY, Example 04-15-2016)
Number of dependent children .......................
d.
FILER
SPOUSE
Number of other dependents
..........................
e.
2016
2016
FROM:
TOTAL EXEMPTIONS. Add lines 8a
through 8e. ......................................................
f.
2016
2016
TO:
7a. Filer’s date of birth
7b. Spouse’s date of birth
9. 2016 DEPENDENT STATUS
(MM-DD-YYYY)
(MM-DD-YYYY)
Check the box if you or your spouse can be claimed
as a dependent on another person’s tax return.
Column A:
Column B:
Taxable Resident
Taxable Nonresident
PART 1: INCOME
Income
Income
00
00
10. Wages, salaries, tips, etc. (see instructions). ........................................ 10.
XXXXXX
00
11. Taxable interest ..................................................................................... 11.
XXXXXX
00
12. Ordinary dividends................................................................................. 12.
XXXXXX
00
13. Alimony received ................................................................................... 13.
00
00
14. Net profit or (loss). Attach copy of U.S. Schedule C or Schedule F. ..... 14.
15. Gain or (loss) on sale or exchange of real or tangible or intangible
00
00
property. ................................................................................................. 15.
XXXXXX
00
16. Early distribution of IRA. ........................................................................ 16.
XXXXXX
00
17. Early distribution of pensions and annuities. ......................................... 17.
00
00
18. Rental real estate and royalties. Attach a copy of U.S. Schedule E....
18.
00
00
19. Partnerships and trusts........................................................................
19.
XXXXXX
20. Other income.
00
Describe: _______________________________________________
20.
00
00
21. SUBTOTAL. Add lines 10 through 20. .................................................. 21.
+
0000 2016 103 01 27 9
Continue on page 2. This form cannot be processed if pages 2 and 3 are not completed and attached.
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