Form L-1040 2017 Individual Income Tax Return - CITY OF LAPEER, Michigan

Form L-1040 is a Michigan Department of Treasury - issued form also known as the "Individual Income Tax Return".

Download a PDF version of the latest Form L-1040 down below or find it on the Michigan Department of Treasury Forms website.

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2017 L-1040
CITY OF LAPEER INDIVIDUAL INCOME TAX RETURN
DUE April 30, 2018
TAXPAYER’S FIRST NAME, MIDDLE INITIAL, AND LAST NAME
YOUR SOCIAL SECURITY NUMBER
YOUR OCCUPATION
IF JOINT RETURN, SPOUSE’S FIRST NAME, MIDDLE INITIAL, AND LAST NAME
SPOUSE’S SOCIAL SECURITY NUMBER
SPOUSE’S OCCUPATION
CURRENT HOME ADDRESS (NUMBER AND STREET INCLUDING APARTMENT NUMBER)
IF MARRIED, IS SPOUSE FILING A SEPARATE RETURN? YES
NO
If Yes - Spouse’s Name and SSN:
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
ENTER NAME AND ADDRESS USED ON 2016 RETURN IF DIFFERENT
RESIDENCY STATUS:
RESIDENT
NONRESIDENT
PART-YEAR RESIDENT
FROM ________/_______/2017 TO _______/________/2017
EXEMPTIONS 1a
Yourself
Spouse
65 or over
Blind
Disabled
Deaf 1b.
65 or over
Blind
Disabled
Deaf
Name of Dependent
Social Security Number
Relationship
Date of Birth
Number of boxes checked
Number of dependents listed
1c.
1d.
1e.
Total Exemptions
(Enter on line 17)
1f.
INCOME
Resident-report all income earned regardless of where earned. Nonresident-report all income earned in City. Include Wages, Tips and other Compensation
(Deferred compensation distributions, sick pay etc). Wages earned in and out of the City by the same employer should be allocated on Page 2, line 27.
Wages from W-2, Box
ATTACH TO
Employer’s Name
Where you work
Income Tax Withheld
1
BACK OF THIS
2a
.00
.00
RETURN
COPY OF
2b
.00
.00
PAGE 1 OF
2c
.00
.00
FEDERAL
2d
.00
.00
FORM 1040
2e Total for additional employers from attached sheet
.00
.00
AND
SCHEDULES
3
TOTAL COMPENSATION AND LAPEER TAX WITHHELD
3a
.00
3b
.00
4 Taxable interest
Attach copy of Page 1 of Federal 1040
4
.00
5 Ordinary dividends
Attach copy of Page 1 of Federal 1040
5
.00
6 Business and farming income from Page 2, line 28f
Attach copy of Federal Schedule C
6
.00
7 Capital gains or losses
Attach copy of Federal Schedule D
7
.00
ATTACH
8 Rental real estate, royalties, partnerships, trusts, etc. from Page 2, line 30d
Attach copy of Federal Schedule E
8
.00
W-2
FORMS
9 Other income total from Page 2, line 31f
(UNEMPLOYMENT IS NOT TAXABLE INCOME TO THE CITY)
9
.00
HERE
10
TOTAL INCOME ADD LINES 3B THROUGH 9
10
.00
DEDUCTIONS
11 Individual Retirement Account
Attach copy of Page 1 of Federal 1040
11
.00
12 Employee business expenses
Attach copy of Federal Schedule 2106
12
.00
ENCLOSE
13 Moving expenses
Attach Federal Form 3903 or list
13
.00
CHECK OR
14 Alimony paid – DO NOT INCLUDE CHILD SUPPORT
Attach copy of Page 1 of Federal 1040
14
.00
MONEY
ORDER
15
TOTAL DEDUCTIONS. ADD LINES 11 THROUGH 14
15
.00
FOR TAX
16
TOTAL INCOME AFTER DEDUCTIONS. SUBTRACT LINE 15 FROM LINE 10
16
.00
DUE
17 Amount for exemptions. Number of exemptions ________ times exemption amount of $600.00
17
.00
(DO NOT
18
TOTAL INCOME SUBJECT TO TAX. SUBTRACT LINE 17 FROM LINE 16
18
.00
STAPLE
TO
CALCULATE CITY OF LAPEER TAX :
RETURN)
19
Multiply Line 18 by .01 for Residents, .005 for Nonresidents or amount from Part-year resident Schedule P
19
.00
PAYMENTS AND CREDITS
(If line 24 exceeds $100 see instructions for making estimated tax payments)
20 Tax withheld by your employer from line 3a above
20
.00
21 Payments on 2017 Declaration of Estimated Income Tax, extension and credit forward
21
.00
22 Credit for tax paid to another city and/or for tax paid by a partnership. Attach copy of other city’s return
22
.00
23
TOTAL PAYMENTS AND CREDITS ADD LINES 20 THROUGH 22
23
.00
TAX DUE
>>>> PAY WITH RETURN
24. If tax (line 19 is larger than payments (line 23)
24
.00
Check, money order or for direct withdrawal mark 27 a ,c ,d, e, f below
OVERPAYMENT
25. If payments (line 23) are larger than tax (line 19)
>>>> REFUND
25
.00
For direct deposit mark 27 b, d, e, f below
CREDIT TO 2018
>>>> CREDIT FORWARD
26. Overpayment to be HELD and APPLIED TO NEXT YEAR ESTIMATED TAX
26
.00
ELECTRONIC REFUND OR PAYMENT INFORMATION
27 a. TAX DUE – DIRECT WITHDRAWAL
b. REFUND – DIRECT DEPOSIT
c. Electronic funds withdrawal effective date:
______/______/______
d. Account Type:
SAVINGS
CHECKING
(if blank, default is date return processed)
e. Routing No.
___ ___ ___ ___ ___ ___ ___ ___ ___ f. Account No. ___ ____ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
MUST BE 9 DIGITS
SIGNATURES ARE REQUIRED ON PAGE 2
MAKE CHECK OR MONEY ORDER PAYABLE TO: CITY OF LAPEER OR PAY WITH ELECTRONIC FUNDS WITHDRAWAL
MAIL RETURN TO: Lapeer City Income Tax Department, 576 Liberty Park, Lapeer, MI 48446
2017 L-1040 PAGE 1
2017 L-1040
CITY OF LAPEER INDIVIDUAL INCOME TAX RETURN
DUE April 30, 2018
TAXPAYER’S FIRST NAME, MIDDLE INITIAL, AND LAST NAME
YOUR SOCIAL SECURITY NUMBER
YOUR OCCUPATION
IF JOINT RETURN, SPOUSE’S FIRST NAME, MIDDLE INITIAL, AND LAST NAME
SPOUSE’S SOCIAL SECURITY NUMBER
SPOUSE’S OCCUPATION
CURRENT HOME ADDRESS (NUMBER AND STREET INCLUDING APARTMENT NUMBER)
IF MARRIED, IS SPOUSE FILING A SEPARATE RETURN? YES
NO
If Yes - Spouse’s Name and SSN:
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
ENTER NAME AND ADDRESS USED ON 2016 RETURN IF DIFFERENT
RESIDENCY STATUS:
RESIDENT
NONRESIDENT
PART-YEAR RESIDENT
FROM ________/_______/2017 TO _______/________/2017
EXEMPTIONS 1a
Yourself
Spouse
65 or over
Blind
Disabled
Deaf 1b.
65 or over
Blind
Disabled
Deaf
Name of Dependent
Social Security Number
Relationship
Date of Birth
Number of boxes checked
Number of dependents listed
1c.
1d.
1e.
Total Exemptions
(Enter on line 17)
1f.
INCOME
Resident-report all income earned regardless of where earned. Nonresident-report all income earned in City. Include Wages, Tips and other Compensation
(Deferred compensation distributions, sick pay etc). Wages earned in and out of the City by the same employer should be allocated on Page 2, line 27.
Wages from W-2, Box
ATTACH TO
Employer’s Name
Where you work
Income Tax Withheld
1
BACK OF THIS
2a
.00
.00
RETURN
COPY OF
2b
.00
.00
PAGE 1 OF
2c
.00
.00
FEDERAL
2d
.00
.00
FORM 1040
2e Total for additional employers from attached sheet
.00
.00
AND
SCHEDULES
3
TOTAL COMPENSATION AND LAPEER TAX WITHHELD
3a
.00
3b
.00
4 Taxable interest
Attach copy of Page 1 of Federal 1040
4
.00
5 Ordinary dividends
Attach copy of Page 1 of Federal 1040
5
.00
6 Business and farming income from Page 2, line 28f
Attach copy of Federal Schedule C
6
.00
7 Capital gains or losses
Attach copy of Federal Schedule D
7
.00
ATTACH
8 Rental real estate, royalties, partnerships, trusts, etc. from Page 2, line 30d
Attach copy of Federal Schedule E
8
.00
W-2
FORMS
9 Other income total from Page 2, line 31f
(UNEMPLOYMENT IS NOT TAXABLE INCOME TO THE CITY)
9
.00
HERE
10
TOTAL INCOME ADD LINES 3B THROUGH 9
10
.00
DEDUCTIONS
11 Individual Retirement Account
Attach copy of Page 1 of Federal 1040
11
.00
12 Employee business expenses
Attach copy of Federal Schedule 2106
12
.00
ENCLOSE
13 Moving expenses
Attach Federal Form 3903 or list
13
.00
CHECK OR
14 Alimony paid – DO NOT INCLUDE CHILD SUPPORT
Attach copy of Page 1 of Federal 1040
14
.00
MONEY
ORDER
15
TOTAL DEDUCTIONS. ADD LINES 11 THROUGH 14
15
.00
FOR TAX
16
TOTAL INCOME AFTER DEDUCTIONS. SUBTRACT LINE 15 FROM LINE 10
16
.00
DUE
17 Amount for exemptions. Number of exemptions ________ times exemption amount of $600.00
17
.00
(DO NOT
18
TOTAL INCOME SUBJECT TO TAX. SUBTRACT LINE 17 FROM LINE 16
18
.00
STAPLE
TO
CALCULATE CITY OF LAPEER TAX :
RETURN)
19
Multiply Line 18 by .01 for Residents, .005 for Nonresidents or amount from Part-year resident Schedule P
19
.00
PAYMENTS AND CREDITS
(If line 24 exceeds $100 see instructions for making estimated tax payments)
20 Tax withheld by your employer from line 3a above
20
.00
21 Payments on 2017 Declaration of Estimated Income Tax, extension and credit forward
21
.00
22 Credit for tax paid to another city and/or for tax paid by a partnership. Attach copy of other city’s return
22
.00
23
TOTAL PAYMENTS AND CREDITS ADD LINES 20 THROUGH 22
23
.00
TAX DUE
>>>> PAY WITH RETURN
24. If tax (line 19 is larger than payments (line 23)
24
.00
Check, money order or for direct withdrawal mark 27 a ,c ,d, e, f below
OVERPAYMENT
25. If payments (line 23) are larger than tax (line 19)
>>>> REFUND
25
.00
For direct deposit mark 27 b, d, e, f below
CREDIT TO 2018
>>>> CREDIT FORWARD
26. Overpayment to be HELD and APPLIED TO NEXT YEAR ESTIMATED TAX
26
.00
ELECTRONIC REFUND OR PAYMENT INFORMATION
27 a. TAX DUE – DIRECT WITHDRAWAL
b. REFUND – DIRECT DEPOSIT
c. Electronic funds withdrawal effective date:
______/______/______
d. Account Type:
SAVINGS
CHECKING
(if blank, default is date return processed)
e. Routing No.
___ ___ ___ ___ ___ ___ ___ ___ ___ f. Account No. ___ ____ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
MUST BE 9 DIGITS
SIGNATURES ARE REQUIRED ON PAGE 2
MAKE CHECK OR MONEY ORDER PAYABLE TO: CITY OF LAPEER OR PAY WITH ELECTRONIC FUNDS WITHDRAWAL
MAIL RETURN TO: Lapeer City Income Tax Department, 576 Liberty Park, Lapeer, MI 48446
2017 L-1040 PAGE 1
FAILURE TO ATTACH DOCUMENTATION OR ATTACHING INCORRECT OR INCOMPLETE DOCUMENTATION
WILL RESULT IN DEDUCTIONS AND LOSSES BEING DISALLOWED OR DELAY PROCESSING OF RETURN
27. WAGE ALLOCATION
COMPUTATION OF LAPEER WAGES OF A NONRESIDENT WHO WORKS BOTH IN AND OUTSIDE OF LAPEER FOR THE SAME EMPLOYER.
WAGES FROM LINE 27f ARE TO BE ENTERED ON THE APPROPRIATE LINE OF PAGE 1, LINES 2a THROUGH 2e, COLUMN “Wages from W-2, Box 1”
27a Employer Name. (A COMPUTATION MUST BE MADE FOR EACH EMPLOYER)
1
2
3
4
27b Actual number of days or hours worked for employer. (DO NOT INCLUDE WEEKENDS OFF,
HOLIDAYS, SICK OR VACATION DAYS, ETC. IN AMOUNTS ON 27b and 27c
27c Actual number of days or hours worked in Lapeer
27d Percentage of days or hours worked in Lapeer. Line 27c divided by line 27b
%
%
%
%
27e Total wages shown on LW-2 or W-2 box 1.
.00
.00
.00
.00
27f Wages earned in Lapeer. Line 27e multiplied by percentage on line 27d
.00
.00
.00
.00
Enter on page 1, lines 2a through 2e, in column “Wages from W-2, Box 1” the Lapeer wages from 27f for each employer
28. BUSINESS AND FARMING INCOME
.00
28a Net profit (or loss) from business, profession or farm. (ATTACH FEDERAL SCHEDULE C OR SCHEDULE F
%
28b Allocation percentage from line 29g below. (IF ALL BUSINESS WAS CONDUCTED IN LAPEER ENTER 100%)
.00
28c Allocated net profit (loss). Multiply line 28a by line 28b
.00
28d Applicable portion of net operating loss carryover. (ATTACH SCHEDULE)
.00
28e Applicable portion of retirement plan deduction.
Check type of plan
KEOGH
SEP
SIMPLE (Attach federal schedule)
.00
28f Total. Lines 28c less lines 28d and 28e. ENTER HERE AND ON PAGE 1 LINE 6
29. BUSINESS ALLOCATION FORMULA
For use by nonresident to compute excludible business income
COLUMN 1
COLUMN 2
COLUMN 3
LOCATED
LOCATED IN
PERCENTAGE
BUSINESS FEIN:
EVERYWHERE
LAPEER
(COLUMN 2
DIVIDED BY
29a Average net book value of real tangible personal property
.00
.00
COLUMN 1)
29b Annual gross rent paid on real property multiplied by 8.
.00
.00
29c Total property. Add lines 29a and 29b
.00
.00
%
29d Total wages, salaries and other compensation of all employees
.00
.00
%
29e Gross receipts from sales made or services rendered
.00
.00
%
29f Total percentages. Add the percentages computed in column 3 lines 29c, 29d and 29e
%
29g Business Allocation Percentage. Divide line 29f by the number of factors used ENTER HERE AND ON LINE 28B ABOVE
%
30. RENTAL REAL ESTATE, ROYALTIES, PARTNERSHIPS, TRUSTS, ETC.
THE FEDERAL RULES CONCERNING PASSIVE LOSSES ARE APPLICABLE TO LOSSES DEDUCTED ON THIS RETURN. SUBCHAPTER S GAINS ARE NOT TAXABLE AND
SUBCHAPTER S LOSSES ARE NOT DEDUCTIBLE ON INDIVIDUAL RETURNS UNDER THE LAPEER INCOME TAX ORDINANCE.
30a Rental real estate from federal Schedule E. (ATTACH FEDERAL SCHEDULE E AND FORM 8582)
.00
30b Partnership, estates, trusts from federal Schedule E. (ATTACH FEDERAL SCHEDULE E AND SCHEDULE K-1)
.00
30c Subchapter S distributions. (ATTACH A COPY OF FEDERAL SCHEDULE K-1)
.00
30d Total. Add lines 30a, 30b and 30c. ENTER HERE AND ON PAGE 1, LINE 8
.00
31. OTHER INCOME
OTHER INCOME INCLUDES: GAMBLING & LOTTERY WINNINGS, ALIMONY RECEIVED, PROFIT SHARING PLAN DISTRIBUTIONS, PREMATURE IRA DISTRIBUTIONS,
PREMATURE PENSION PLAN DISTRIBUTIONS, ETC. ATTACH COPIES OF ALL FEDERAL SCHEDULES AND FORMS 1099.
RECEIVED FROM
KIND OF INCOME
AMOUNT
31a
.00
31b
.00
31c
.00
31d
.00
31e
.00
31f Total. Add lines 31a through 31e. ENTER HERE AND ON PAGE 1, LINE 9
.00
THIRD PARTY DESIGNEE
Please check appropriate box. Yes you may discuss my return with my preparer
Do not discuss my return with my preparer
I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct and complete. If
prepared by a person other than taxpayer, the preparer’s declaration is based on all information of which preparer has any knowledge.
___________________________________________________/____/____ _______________________________________________/____/____
TAXPAYER’S SIGNATURE – If joint return both husband and wife must sign.
DATE
SIGNATURE OF PREPARER OTHER THAN TAXPAYER
DATE
__________________________________________________/____/____
________________________________________________________
SPOUSE’S SIGNATURE
DATE
PREPARER’S ADDRESS
DAYTIME PHONE NUMBER (_______)_______________________________
PREPARER’S PHONE NUMBER (_______)___________________________________
E-MAIL ADDRESS_________________________________________________
2017 L-1040 PAGE 2
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