Form F-1040 - City Of Flint Individual Income Tax Return - 2015
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2015
F-1040
FLINT
15MI-FLT1
INDIVIDUAL RETURN DUE APRIL 30, 2016
Taxpayer's SSN
Taxpayer's first name
Initial Last name
RESIDENCE STATUS
Part-year
Resident
Nonresident
resident
Spouse's SSN
If joint return spouse's first name
Initial Last name
Part-year resident - dates of residency (mm/dd/yyyy)
From
Present home address (Number and street)
Apt. no.
To
Mark (X) box if deceased
FILING STATUS
Taxpayer
Spouse
Address line 2 (P.O. Box address for mailing use only)
Single
Married filing jointly
Enter date of death on page 2, right
Married filing separately. Enter spouse's
side of signature area.
City, town or post office
State
Zip code
SSN in Spouse's SSN box and Spouse's full
Mark (X) below if form attached
name here.
Federal Form 1310
Foreign country name
Foreign province/county
Foreign postal code
Spouse's full name if married filing separately
Supporting Notes and
Statements (attachment 22)
ROUND ALL FIGURES TO NEAREST DOLLAR
Column A
Column B
Column C
INCOME
(Drop amounts under $0.50 and increase
Federal Return Data
Exclusions/Adjustments
Taxable Income
amounts from $.50 to $0.99 to next dollar)
.00
.00
.00
1.
Wages, salaries, tips, etc. ( W-2 forms must be attached)
1
ATTACH
.00
.00
.00
2.
Taxable interest
2
COPY OF
.00
.00
.00
PAGE 1 OF
3.
Ordinary dividends
3
FEDERAL
.00
.00
Taxable refunds, credits or offsets of state and local income taxes
NOT TAXABLE
4.
4
RETURN
.00
.00
.00
5.
Alimony received
5
.00
.00
.00
Business income or (loss) (Attach copy of federal Schedule C)
6.
6
Capital gain or (loss)
7.
Mark if federal
(Attach copy of fed. Sch. D)
.00
.00
.00
7a.
Sch. D not required
.00
.00
.00
8.
Other gains or (losses) (Attach copy of federal Form 4797)
8
.00
.00
.00
9.
Taxable IRA distributions (Attach copy of Form(s) 1099-R)
9
.00
.00
.00
10.
Taxable pensions and annuities (Attach copy of Form(s) 1099-R)
10
Rental real estate, royalties, partnerships, S corporations, trusts,
11.
etc. (Attach copy of federal Schedule E)
.00
.00
.00
11
NOT APPLICABLE
12.
Reserved
12
.00
.00
.00
13.
Farm income or (loss) (Attach copy of federal Schedule F)
13
ATTACH
.00
.00
NOT TAXABLE
14.
Unemployment compensation
14
W-2
FORMS
.00
.00
NOT TAXABLE
15.
Social security benefits
15
HERE
.00
.00
.00
16.
Other income (Attach statement listing type and amount)
16
.00
.00
.00
17.
Total additions (Add lines 2 through 16)
17
.00
.00
.00
18.
Total income (Add lines 1 through 16)
18
.00
19.
Total deductions (Subtractions) (Total from page 2, Deductions schedule, line 7)
19
.00
20.
Total income after deductions (Subtract line 19 from line 18)
20
(Enter the total exemptions, from Form F-1040, page 2, box 1h, in line 21a and multiply this
21.
Exemptions
number by $600 and enter on line 21b)
.00
21a
21b
.00
22.
Total income subject to tax (Subtract line 21b from line 20)
22
(Multiply line 22 by Flint resident tax rate of 1.% (0.01) or nonresident tax rate of 0.5% (0.005)
23.
Tax at {tax rate}
and enter tax on line 23b, or if using Schedule TC to compute tax, check box 23a and enter tax
.00
23a
23b
from Schedule TC, line 23d)
Other tax payments (est, extension,
Credit for tax paid
Payments
Total
Flint tax withheld
cr fwd, partnership & tax option corp)
to another city
24.
and
payments
.00
.00
.00
.00
24d
24a
24b
24c
Credits
& credits
Interest and penalty for: failure to make
Total
Interest
Penalty
25.
estimated tax payments; underpayment of
interest &
.00
.00
.00
25a
25b
25c
estimated tax; or late payment of tax
penalty
Amount you owe (Add lines 23b and 25c, and subtract line 24)
ENCLOSE
PAY WITH
TAX DUE
26.
MAKE CHECK OR MONEY ORDER PAYABLE TO: CITY OF FLINT
CHECK OR
.00
RETURN
26
IF PAID ON LINE CREDITCARD/ELECTRONIC CHECK ENTER CONFIRMATION #
MONEY
.00
OVERPAYMENT
ORDER
27. Tax overpayment (Subtract lines 23b and 25c from line 24d; choose overpayment options on lines 28 - 30)
27
Amount of
Flint Indigent Water Fund
28.
overpayment
Total
.00
.00
28d
28a
28b
28c
donated
donations
.00
29.
Amount of overpayment credited forward to 2016
Amount of credit to 2016 >>
29
Amount of overpayment refunded (Line 27 less lines 28d and 29) (For refund to be directly deposited to
30.
your bank account, mark refund box, line 31a, and complete line 31 c, d & e)
.00
Refund amount >>
30
Refund
Routing
31a
31c
(direct deposit)
number
Direct deposit refund
Account
31.
(Mark (X) box 31a and
31b
Not available
31d
complete lines 31c, 31d
number
and 31e)
31e
Account Type:
Checking
Savings
MAIL REFUND AND CREDIT FORWARD RETURNS TO: FLINT INCOME TAX DEPARTMENT, PO BOX 2055, FLINT, MI 48501-2055
Revised: 01/20/2016
MAIL TAX DUE AND NO REFUND NO TAX DUE RETURNS TO: FLINT INCOME TAX DEPARTMENT, PO BOX 1800, FLINT, MI 48501-1800
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