Form Bc1040 - Income Tax Individual Return - City Of Battle Creek - 2000

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2000
2000
2000
2000
2000
BC1040
BC1040
BC1040
BC1040
BC1040
CHECK
RESIDENT
FOR CALENDAR YEAR 2000
ONE
NONRESIDENT
CITY OF BA
CITY OF BAT T T T T TLE CREEK INCOME T
CITY OF BA
TLE CREEK INCOME T
TLE CREEK INCOME TAX
TLE CREEK INCOME T
AX AX
AX AX
CITY OF BA
CITY OF BA
TLE CREEK INCOME T
OR FISCAL YEAR ENDING____________
BOX
PART-YEAR RESIDENT
INDIVIDUAL RETURN
INDIVIDUAL RETURN
INDIVIDUAL RETURN
INDIVIDUAL RETURN
INDIVIDUAL RETURN
Taxpayer's Social Security No.
Spouse's Social Security No.
First Name(s) and Middle Initial(s)
Last Name
Present Home Street Address
(Post Office Box No.)
City, Town or Post Office
State
Postal Zip Code
Did you file a 1999 Battle Creek Return?
Yes
No
If yes, are the Name(s) and Address the same? If not, check this box
No
DO NOT WRITE IN THIS SPACE
Present employer's name_____________________________________
FILING STATUS:
No. of boxes
EXEMPTIONS:
__________________________
__________________________
checked
(Your Birth Date)
(Spouse's Birth Date)
MARRIED FILING JOINTLY
YOURSELF
65 & Over
SPOUSE
65& Over
No. of children
MARRIED FILING SEPARATE
Blind
Deaf
Disabled
Blind
Deaf
Disabled
who lived
with you
BC 1040 RETURNS, ENTER:
(All Disabilities Require Doctor's Statement(s) be Attached.)
Dependents
Check if
If age 1 or over dependents
No. of months lived
Relationship
No. of children
Name (first, Initial, and last name)
under age 1
social security number
in your home
who didn't live
with you
_______________________________________
due to a divorce
SPOUSE'S NAME
No. of other
dependents
_______________________________________
SPOUSE'S SOCIAL SECURITY #
Add numbers
entered in
SINGLE
If your child didn't live with you but is claimed as your dependent under pre-1985 agreement check here .........................................................
boxes above
T T T T T otal number of exemptions claimed
otal number of exemptions claimed
otal number of exemptions claimed
...........................................................................................................................................................................................................
...........................................................................................................................................................................................................
otal number of exemptions claimed
otal number of exemptions claimed ...........................................................................................................................................................................................................
...........................................................................................................................................................................................................
........................................................................................................................................................................................................... .
1. TOTAL W-2 INCOME: Wages, salaries, tips, etc. (Attach all W-2’s on the back of this form)
00
A. NONRESIDENTS REFER TO NONRESIDENT INSTRUCTIONS .................................................................... 1.
00
2. ADDITIONS TO INCOME: All other income; interest, dividends, business income, capital gains, ........................... 2.
rents, royalties, partnerships, estates, trusts, farm, etc. (ATTACH ALL SCHEDULES AND EXPLANATIONS)
00
3. SUBTRACTIONS FROM INCOME: All allowed losses and adjustments per instructions ........................................ 3.
(ATTACH ALL SCHEDULES AND EXPLANATIONS)
00
4. ADJUSTED INCOME: Add lines 1 and 2 less line 3: ................................................................................................ 4.
00
5. EXEMPTIONS: Multiply the number of exemptions claimed by $1500.00 ................................................................ 5.
00
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 ) ............................................................................................................................
00
B. NONRESIDENT ONLY - 1/2% (.005) .............................................................................................................. 7.
C. PART-YEAR RESIDENT - Tax from Schedule 3, line I ..........(Check this box) ..................................................
Inv.
Date
PAYMENTS AND TAX CREDITS
Tax
00
8. Battle Creek tax withheld (Attach W-2 supplied by employer) ............................................ 8.
Fees
00
9. 2000 Estimate payments (including credit from 1999 overpayment) ................................. 9.
Total
10. Credit for income tax paid to another Michigan municipality
00
or by a partnership (Name __________________________) ATTACH COPIES ........ 10.
00
11. TOTAL PAYMENTS AND CREDITS: Add lines 8, 9 and 10. ................................................................................... 11.
00
12. BALANCE DUE line 7 larger than line 11 ............................................................................................................... 12.
PAY WITH RETURN
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
(Make checks payable to City Treasurer)
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
13. OVERPAYMENT: line 11 larger than line 7.
00
A. Amount to be Refunded ................................................................................................................................. 13A.
B. Amount to be Credited to 2001 Estimated tax ................................................................................................ 13B.
00
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my
knowledge and belief, they are true, correct and complete.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SIGN HERE
SIGN
(Taxpayer's signature and date)
(Signature of preparer other than taxpayer and date)
HERE
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SIGN HERE
(Spouse's signature and date)
(Address)
(Telephone #)
. . . . . . . . . . . . . . . . . . . . . . . . .
TELEPHONE #
Mail returns with payments to: BATTLE CREEK CITY TREASURER, P.O. BOX 1982, BATTLE CREEK, MI 49016-1982
Mail refunds and other returns to: CITY INCOME TAX DIVISION, P.O. BOX 1657, BATTLE CREEK, MI 49016-1657
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