Form Sp-2012 - Combined Tax Return For Individuals - 2012
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1COMBINED TAX RETURN
FORM SP-2012
FOR INDIVIDUALS
Multnomah County
2012 CALENDAR YEAR
Business Income Tax
City of Portland
DUE DATE: APRIL 15, 2013
Business License Tax
TAXABLE YEAR
From: 1/1/2012 to 12/31/2012
(Attach explanation if not a calendar year filer.)
ACCOUNT #
SOCIAL SECURITY #
FEIN #
FEDERAL BUSINESS CODE
OFFICIAL USE ONLY
NAME
MAILING ADDRESS (Notify the Revenue Bureau if business location address changes)
STATE/PROV ZIP CODE
CITY
JOINT VENTURE /
CHECK ALL THAT APPLY
AMENDED RETURN?
CEASED PORTLAND/MULTNOMAH BUSINESS?
1 MEMBER
TENANT-IN-COMMON
SOLE PROPRIETORSHIP
(attach explanation)
MAILING ADDR CHANGE?
LLC
(PARTIAL OWNER)
ATTACH PAGE 1 OF FEDERAL FORM 1040 ___
1.
Net Income or (Loss) from Federal Schedule C (Attach all Schedule Cs) ........................................
1
2.
Business Income Tax & Business License Tax Add Back....................................................................
2
3.
Net Income or (Loss) from Federal Schedule E, D, etc. (Attach Schedule E, D, etc.) .......................
3
4.
Subtract Deductible SE Tax (see instructions for other additions and subtractions) ...........................
4
5.
Adjusted Net Income (total lines 1, 2, 3 and 4).....................................................................................
5
(
)
6.
Compensation Allowance Deduction (see instructions)
...........................................
6
(# owners______)
Enter as negative sum
7.
Subject Net Income (line 5 minus line 6) .............................................................................................
7
Multnomah County Business Income Tax
Average Sum of Multnomah Employees in 2012:
8.
8a.
County Gross Income
.........
8c = (8a ÷ 8b) Cannot be more than 1.0
8c
=
.
8b.
Total Gross Income*
* *If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common)
9.
County Apportioned Net Income (line 7 x line 8c) ..............................................................................
9
(
)
10. Net Operating Loss Deduction (max 75% of line 9) .............................................................................
10
Enter as negative sum
11. Income Subject to Tax (line 9 minus line 10) .......................................................................................
11
12. Tax (line 11 x tax rate of 1.45%) MINIMUM $100 ...............................................................................
12
(
)
13. Prepayments .......................................................................................................................................
Enter as negative sum
13
14. Penalty ................................................................................................................................................
14
15. Interest ................................................................................................................................................
15
16. Balance Due or (Overpayment)
.........................................................
— Allocate overpayment on line 17
16
17.
REFUND:
CREDIT:
TRANSFER TO PORTLAND:
City of Portland Business License Tax
Average Sum of Portland Employees in 2012:
18a.
18. Portland Gross Income
.........
18c = (18a ÷ 18b) Cannot be more than 1.0
18c
=
.
18b.
Total Gross Income*
*If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common)
19. Portland Apportioned Net Income (line 7 x line 18c) ..........................................................................
19
(
)
20. Net Operating Loss Deduction (max 75% of line 19) ...........................................................................
Enter as negative sum
20
21. Income Subject to Tax (line 19 minus line 20) .....................................................................................
21
22. Tax (line 21 x tax rate of 2.2%) MINIMUM $100 .................................................................................
22
(
)
23. Prepayments .......................................................................................................................................
23
Enter as negative sum
24. Penalty ................................................................................................................................................
24
25. Interest ................................................................................................................................................
25
26. Balance Due or (Overpayment)
..........................................................
— Allocate overpayment on line 27
26
27.
REFUND:
CREDIT:
TRANSFER TO MULT CO:
DONATE TO “WORK FOR ART”:
COMBINED AMOUNT DUE WITH REPORT
28.
(total lines 16 and 26) Check #___________ ..........
28
Make check payable to City of Portland, 111 SW Columbia St., Suite #600, Portland, OR 97201-5840.
The undersigned declares that the information given on this report is true. The undersigned is authorized to act as a representative of the filer. Filers of
incomplete returns (including returns that have not reported the Average Sum of Employees) may be subject to civil penalties of up to $500.
Signature of Filer
__________________________________________
__________________
(
)_______________
Date
Filer’s Daytime Phone
_______________________________________
__________________
___________________________
Signature of Preparer
Date
Filer’s Email
Preparer’s Name/Address
____________________________________________________________
(
)__________________
Preparer Phone
REVENUE BUREAU (503) 823-5157
FAX (503) 823-5192
TDD (503) 823-6868
SP-2012 Rev 1/11/2013
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