Form Bc-1040 X - Amended Individual Income Tax Return

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AMENDED
RESIDENT
CHECK
INDIVIDUAL INCOME
BC-1040 X
ONE
NONRESIDENT
BOX
PART-TEAR RESIDENT
TAX RETURN
ENTER CALENDAR YEAR OR ENDING DATE OF FISCAL YEAR (MO./DAY/YR.) OF THIS RETURN__________/___________/_________
PART I
IDENTIFICATION
(Please type or print)
Your first name & middle initial (if joint, also give spouse's name)
Last name
Present home address (number & street, including apartment)
Your social security no.
City, town or post office, State and ZIP code
Spouse's social security no.
DO NOT WRITE IN THIS SPACE
IMPORTANT: Please answer all questions, fill in applicable items, and explain changes on Page 2.
Enter name and address on original return (if same as above, write "Same"). If changing from separate to joint return, enter names and addresses used on original returns.
(NOTE you cannot change from joint to separate returns after the due date has passed for filing separate returns)
On Original Return
❑ Resident
❑ Non-resident
❑ Part-year resident, from ______________ to _____________
Residency
Status
On This Return
Claimed
❑ Resident
❑ Non-resident
❑ Part-year resident, from ______________ to _____________
Married
Married
Exemptions:
Single
filing jointly
filing separately
Filing
On Original Return ___________
On This Return __________
On Original Return ..................................
Status
On This Return
..................................
Claimed
B. Net Change
C. Correct
A. As originally
Give Name of Spouse:_________________________________________
(increase or
Amount
reported or as
decrease - explain
adjusted (see
PART II
INCOME, ADDITIONS, and DEDUCTIONS
on Page 2)
specific inst.)
1. TOTAL W-2 INCOME: (wages, salaries, tips, etc.) (Attach all W-2's)
A. RESIDENTS: enter total W-2 income
B. NONRESIDENTS (See instructions ................................... 1.
2. ADDITIONS TO INCOME: All other income: (interest, dividends, business income, capital gains, rents,
royalties, partnerships, estates, trusts, farm, etc.) ......................................................................................... 2.
(ATTACH ALL SCHEDULES AND EXPLANATIONS)
3. SUBTRACTIONS FROM INCOME (All allowed losses and adjustments.) ...................................................... 3.
(See instructions)
(ATTACH ALL SCHEDULES AND EXPLANATIONS)
4. ADJUSTED INCOME (Add lines 1 and 2 less line3.) ....................................................................................... 4.
5. EXEMPTIONS: Multiply the number of exemptions claimed by (tax year prior to 1992 = $600, tax years
1992 - 1993 = $700, tax year 1994 = $850, 1995 - 1997 = $1,000.00, 1998 - 1999 = $1,500.00) .................. 5.
6. TAXABLE INCOME (line 4 less line 5) .............................................................................................................. 6.
7. TAX - Multiply amount on line 6 by one of the following:
A. RESIDENT ONLY - 1% (.01) ........................................................................................................................ 7.
B. NONRESIDENT ONLY - 1/2% (.005) .............................................................................................................
C. PART-YEAR RESIDENT - Tax from Schedule 3, line 1 ...................................................................................
DO NOT WRITE
PART III
CREDITS AND PAYMENTS
IN THIS SPACE
Inv.
8. Battle Creek tax withheld (Attach W-2 supplied by employer) ....................................................................... 8.
Date
9. Estimate payments (including credit from overpayment) ............................................................................... 9.
Tax
10. Credits for income tax paid to another Michigan municipality or by a partnership ...................................... 10.
Fees
Total
11. TOTAL PAYMENTS AND CREDITS (Add lines 8, 9 and 10.) ......................................................................... 11.
A. Amount paid with original return, plus additional tax paid after filing ........................................................................................ A.
_______________________
B. Total credits and payments. Add lines 11 and A of column C ................................................................................................... B.
_______________________
PART IV
REFUND OR BALANCE DUE
C. Refund, if any, shown on original return line 13 A or B .............................................................................................................. C.
_______________________
D. Enter the difference between lines B and C (see instructions) .................................................................................................. D.
_______________________
12. If line 7, column C is greater than line D, enter BALANCE DUE. Pay in full .............................................................................. 12.
_______________________
13 A. If line 7, column C is less than D, enter REFUND to be received ......................................................................................... 13 A.
_______________________
(OVER)

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