Form 2016lf - Newark Income Tax Page 3
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6Worksheet A - Wage Adjustment
See Worksheet A Instructions for assistance with this form. If you need to complete
this form, we strongly encourage you to call for an appointment or come into our office
so our staff may assist you.
Part 1 - Moved in or out of Newark in 2016
A
B
C
D
E
F
G
# Mo
Box b
W-2
Newark
# Mo
Lived out
C ÷ D
E × F
W-2
A - B
EIN
Wage
Wage
Worked
of
Newark
1
2
3
4
5
Total Adjustment - Enter on line 2 on your tax return.
Part 2 - You turned 18 in 2016
A
B
C
D
E
Box b
W-2
# Mo
# Mo
A ÷ B
C × D
W-2
EIN
Wage
Worked
Under 18
1
2
3
4
5
Total Adjustment - Enter on line 2 of your tax return.
When used, this worksheet is part of your return, please remit a copy with your return.
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