Form Hp 1040 - Individual Income Tax Return - City Of Highland Park

FOR THE YEAR

CITY OF HIGHLAND PARK

2 2 0 0

HP 1040

JANUARY 1 – DECEMBER 31, 2004

INDIVIDUAL INCOME TAX RETURN

or other taxable year ending _______

DUE DATE: APRIL 30, 2005

WE WILL NOT ACCEPT ANY VARIATION OF THIS FORM

Your Social Security Number

Spouse's Social Security Number

Birth Date

Telephone

DO NOT WRITE BELOW

PRIMARY

USE

PEEL-

First Name and Initial

Spouse's First Name and Initial

Last Name

VERIFIED

OFF

ATTACH LABEL HERE

MAILING

□

AUDIT

Home Address (Number and Street or rural route)

Do NOT use P.O. Box

Spouse's Occupation

INQUIRY

LABEL

□

REFUND

□

City, Town, or Post Office and State

Zip

Your Occupation

ASSESS-

MENT

PRESENT EMPLOYER'S NAME

FILING STATUS

□

SINGLE

□

MARRIED, FILING JOINTLY

PRESENT EMPLOYER'S ADDRESS (ACTUAL WORK LOCATION)

□

MARRIED, FILING SEPARATELY – Enter Full

Name and S.S. No. of Spouse (See Instructions)

Regular

65 or over

□

YOURSELF

TOTAL EXEMPTIONS CLAIMED

□

If you can be claimed on Another's Return

SPOUSE

□

CHECK IF

DEPENDENTS - WRITE LAST NAME IF DIFFERENT

SOCIAL SECURITY NUMBER

RELATIONSHIP

MONTHS IN HOME

RESIDENT

UNDER 2

□

NON-RESIDENT

□

USING BOTH RATES – COMPLETE

SCHEDULE 4

RESIDENT FROM _______ TO ______

Report Dollars Only

1. INCOME (Attach copies of all W-2's, Federal schedules and/or documents to substantiate totals):

RESIDENT: Enter total income from 2004 Federal 1040, or 1040A, or 1040EZ (if no additions or

subtractions, carry to line 5) ..............................................................................................................................................................

NON-RESIDENT: Enter GROSS wages from W-2, HPW-2, or Schedule 1NR, page 2, line H .......................................................

(If you have no additions or subtractions, carry this amount to line 5.)

2. ADDITIONS TO INCOME (from page 2, Schedule 1R, line B for Residents or 2NR line E for Non-Residents)........................................................

3. TOTAL INCOME: (line 1 plus line 2) ..........................................................................................................................................................................

4. SUBTRACTIONS FROM INCOME (from page 2, Schedule 1R, line J for Residents or Schedule 2NR,

line I for Non-Residents, if included in line 1 above. Attach all Schedules.)......................................................................................................

5. ADJUSTED INCOME (line 3 less line 4) ....................................................................................................................................................................

6. EXEMPTIONS: Multiply the number of exemptions claimed by $600.00 ...................................................................................................................

7. TAXABLE INCOME (line 5 less line 6) ......................................................................................................................................................................

8. TAX – Multiply amount on line 7 by one of the following:

RESIDENT ONLY – 2% (.02)................................................................................................................................................................

NON-RESIDENT ONLY – 1% (.01) ......................................................................................................................................................

PART-YEAR RESIDENT – Tax from Schedule 4, line M (Copy in back of this booklet) ......................................................................

PAYMENTS AND TAX CREDITS:

MAKE CHECK

Highland Park tax withheld (Attach legible W-2 or HPW-2 showing city tax withheld) ..............................

PAYABLE

10.

2004 estimate payments including credit from 2003 overpayment............................................................ 10.

Fed. I.D. Partnership No.

11.

Payment on tentative return or by partnership

11.

CITY

11A.

Credits for income tax paid to another Michigan City ................................................................................ 11.A

TREASURER

(Residents only) – See Instructions. (Limit = 1% of Detroit's taxable wages)

PLEASE ATTACH DETROIT RETURN

12. TOTAL PAYMENTS AND CREDITS (Add lines 9 through 11A) ...............................................................................................................................

12.

13. If line 8 is larger than line 12 PAY................................................................................................ BALANCE DUE:

Pay In Full With Return

13.

ON OR BEFORE APRIL 30, 2005

(No payment necessary if less than $1.00)

14. If line 12 is larger than line 8, enter............................................................................................................................................... OVERPAYMENT:

14.

15. Line 14 to be:.................................................................................................................................................. (a) credited on 2005 Estimated Tax

15(a)

(Refund of $10.00 or more reported to IRS)

or ................................................................................................................................................................................................. (b) refunded

15(b)

16.

16. Add interest-penalty on balance due, if applicable. (See instructions) .......................................................................................................................

Do not enter amounts less than $1.00 as credit will not be carried forward nor will refunds be made for less than $1.00.

If crediting overpayment (Line 14) to 2005 Estimated Tax, attach Declaration of Estimated Tax for 2005 Form HP 1040ES indicating amount to be credited.

I declare that I have examined this return and accompaniments and to the best of my knowledge and belief it is true, correct and complete.

If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.

Sign here

DATE

DO NOT WRITE BELOW

(TAXPAYER'S SIGNATURE)

(IF JOINT RETURN BOTH HUSBAND AND WIFE MUST SIGN)

RETURN NUMBER

Sign here

DATE

(SPOUSE'S SIGNATURE)

MAIL WITH RETURN PAYMENTS TO