Form 5118 - City Of Detroit Resident Income Tax Return - 2015 Page 2

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2015 Form 5118, Page 2

Filer’s Full Social Security Number

City of Detroit Resident Income Tax Return

PART 4: ADDITIONS TO INCOME (All entries must be positive numbers.)

26. Deductible part of self-employment tax. .......................................................................................................

26.

27. Self-employment health insurance deduction...............................................................................................

27.

28. Other additions.

Describe: __________________________________________________________

28.

29. Total Additions. Add lines 26 through 28. Enter here and on line 10. .......................................................

29.

PART 5: SUBTRACTIONS FROM INCOME (Included in AGI on line 9. All entries must be positive numbers.)

30. IRA, pension, annuity or other retirement benefit distribution.......................................................................

30.

31. Taxable Social Security benefits ...................................................................................................................

31.

32. Interest on U.S. government obligations and gains on the sale of U.S. obligations (see instructions). .......

32.

33. State and local income tax refunds. .............................................................................................................

33.

34. Unemployment compensation. .....................................................................................................................

34.

35. Renaissance Zone deduction. .....................................................................................................................

35.

36. Other subtractions.

Describe: __________________________________________________________

36.

37. Total Subtractions. Add lines 30 through 36. Enter here and on line 12. ..................................................

37.

PART 6: AMENDED RETURN

38. Reason for amending:

PART 7: CERTIFICATION

Deceased Taxpayer.

Preparer Certification.

If Filer and/or Spouse died after December 31, 2014, enter dates below.

I declare under penalty of perjury that

ENTER DATE OF DEATH ONLY.

this return is based on all information of which I have any knowledge.

Example: 04-15-2015 (MM-DD-YYYY)

Preparer’s PTIN, FEIN or SSN

Filer

Spouse

Preparer’s Name (print or type)

Taxpayer Certification.

I declare under penalty of perjury that the information in this return

and attachments is true and complete to the best of my knowledge.

Filer’s Signature

Date

Preparer’s Business Name, Address and Telephone Number

Spouse’s Signature

Date

By checking this box, I authorize the Michigan Department of Treasury to discuss

my return with my preparer.

Refund, credit, or zero returns. Mail your return to:

Michigan Department of Treasury, Lansing, MI 48956

Pay amount on line 22. Mail your check and return to: Michigan Department of Treasury, Lansing, MI 48929

Make your check payable to “State of Michigan - Detroit.” Print the last four digits of your Social Security number and “2015 Detroit Income Tax” on

the front of your check. If paying on behalf of another taxpayer, write the filer’s name and the last four digits of the filer’s Social Security number on

the check. Do not staple your check to the return. Keep a copy of your return and supporting schedules for six years. To check your refund status, have a

copy of your Form 5118 available when you visit

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