Schedule Ct-40ez - Form It-40ez - County Tax Schedule For Indiana Residents - 2012
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1
2Schedule CT-40EZ
County Tax Schedule for Indiana Residents
2012
Form IT-40EZ
Read instructions on page 9 to see if this schedule needs to be attached to your IT-40EZ
State Form 53742
(R5 / 9-12)
Name(s) shown on Form IT-40EZ
Your Social Security Number
Lake County Residents: Read the Special Instructions for Lake County residents on page 10 if you and/or your spouse
lived in Lake County on Jan. 1, 2012. If Lake County adopted an income tax, enter your 4-digit Lake County number(s) below
and complete Section 1. If Lake County did not adopt an income tax, do not fi ll in the 4-digit numbers below, and skip to
Section 2.
Your Lake County 4-digit number.
Spouse’s Lake County 4-digit number.
SECTION 1: To be completed by those taxpayers who were residents of a county that had adopted a county income tax.
1. Enter the amount from IT-40EZ, line 5. Note: If both you and
your spouse lived in the same county on January 1 (or lived in the
same Lake County location on January 1), enter the entire
Column A - Yourself
Column B - Spouse’s
amount from Form IT-40EZ, line 5 on line 1A only.
00
00
See instructions on page 9 _____________________________
1A
1B
2. Enter the resident rate from the chart on the back of this
.
.
schedule for the county where you lived on Jan. 1, 2012 ______
2A
2B
00
00
3. Multiply line 1 by the rate on line 2 _______________________
3A
3B
4. Enter total of lines 3A plus 3B. Continue with Section 2 below if you are married fi ling jointly and
00
you/spouse need to complete it. Otherwise, enter this amount on line 7 of Form IT-40EZ ________
4
SECTION 2: To be completed by those taxpayers who, on Jan. 1, 2012, were residents of a county that had not adopted a
county income tax, but worked in an Indiana county that had adopted a county income tax.
Column A - Yourself
Column B - Spouse’s
1. Enter your wages, salaries, tips and/or commission income from
your principal employment for the year. This income will be
00
00
included on Form IT-40EZ, line 1. See instructions on page 9 _
1A
1B
1000 00
1000 00
2. Exemption _________________________________________
2A
2B
00
00
3. Line 1 minus line 2 ___________________________________
3A
3B
4. Enter the nonresident rate from the chart on the back of this
.
.
schedule for the county where you worked on Jan. 1, 2012 ___
4A
4B
5. Multiply the income on line 3A/B by the nonresident rate
00
00
on Line 4A/B ________________________________________
5A
5B
6. Enter total of 5A plus 5B; carry to Form IT-40EZ, line 7. (If you have an amount on Section 1,
00
line 4 above, combine that with the amount on line 6 and enter total on Form IT-40EZ, line 7) ____
6
16712111694
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