Form E-1 - Individual Earnings Tax Return - City Of St. Louis - 2010
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1
2CALENDAR
CITY OF ST. LOUIS
Form E-1
YEAR
INDIVIDUAL EARNINGS TAX RETURN
(Rev. 3/07)
(Rev. 11/10)
11
(RESIDENT AND NON-RESIDENT)
Telephone: (314) 622-4403
Telephone: (314) 622-3291
PLEASE PRINT YOUR NAME AND
ADDRESS IN THE SPACE BELOW
Social Security No.
Telephone No.
Email Address:
A COPY OF FORM(S) W-2 MUST ACCOMPANY THIS RETURN
1
Salaries, Wages, etc. from Form(s) W-2. See Instructions on Back. For Self-Employed or 1099-MISC Income use Form E-234.
A
$
B
$
C
$
D
$
2
GROSS SALARIES, WAGES, etc. (Total of Lines A, B, C, D (attach Form(s) W-2).
$
3
Non-Residency Deduction (Complete Formula on Reverse Side).
$
4
NET TAXABLE EARNINGS (Subtract line 3 from line 2).
$
5
EARNINGS TAX (1% of line 4).
$
6
Earnings Tax withheld (per Form(s) W-2).
$
7
BALANCE DUE (Subtract line 6 from line 5). No tax is due if balance is under $1.00.
$
8
Taxes paid after April 15 are delinquent. Enter amount from line 7.
$
9
Penalty, see reverse side
%
$
10
Interest, see reverse side
%
$
11 TOTAL AMOUNT DUE Total of lines 8, 9, 10
$
Pursuant to the Revised Code of the City of St. Louis, § 5.22.100, the Collector of Revenue or his duly authorized agent has the
authority to audit facilities or tax returns of an employer or taxpayer subject to this section of the Tax Code.
I declare this return has been examined by me and is true, correct and complete to the best of my knowledge and belief.
(DATE)
(SIGNATURE)
(TYPED OR PRINTED NAME)
PREPARER
PREPARER EIN
PREPARER TELEPHONE
MAKE PAYMENT PAYABLE TO: GREGORY F.X. DALY, COLLECTOR OF REVENUE.
MAIL TO: GREGORY F.X. DALY, COLLECTOR OF REVENUE, EARNINGS TAX DEPT., 410 CITY HALL
1200 MARKET ST., ST. LOUIS, MO 63103.
WEBSITE ADDRESS:
WEBSITE ADDRESS:
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