Form Sf - 1040r - Individual Return Due - 2009
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1
2
32009
2009
INDIVIDUAL RETURN DUE
INDIVIDUAL RETURN DUE
April 30, 2010
April 30, 2010
Your Social Security Number
Spouse's Social Security Number
First Name and Initial
Last Name
If Joint, Spouse's First Name and Initial
Last Name
RESIDENCY STATUS
Mailing Address (If using a PO Box you must also list your physical home address)
RESIDENT
NON-RESIDENT
PART-YEAR RESIDENT
FILING STATUS
City / Town
State
Zip Code
SINGLE
MARRIED FILING JOINTLY
* MARRIED FILING SEPARATELY
Name and address used on 2008 return. If same as above, type "Same" if no return filled, explain:
* IF MARRIED FILING SEPARATELY, SPOUSE'S NAME AND SOCIAL SECURITY NUMBER
EXEMPTIONS
Total number of exemptions (from pg 8)
INCOME
Please round all numbers
ATTACH
Complete and attach Schedule SF-W2 (pg 8)
1.
Wages, salaries, tips, etc.
1.
COPY OF
Taxable interest.
2.
2.
PAGE 1 OF
Ordinary dividends.
3.
3.
FEDERAL
Taxable refunds, credits or offsets.
NOT TAXABLE
4.
4.
RETURN
Alimony received.
5.
5.
Business income. Attach federal Schedule C, pg 1 & 2
6.
6.
Capital gains or losses. Attach federal Schedule D
Check if schedule is not required
7.
7.
Other gains or losses. Attach federal Form 4797
8.
8.
9.
Taxable IRA distributions.
9.
Taxable pension distributions. Attach copy of Form 1099-R
10.
10.
Rental real estate, royalties, partnerships, trusts, etc. Attach federal Schedule E(s)
11.
11.
Subchapter S corporation distributions. Attach federal Schedule K-1
12.
12.
ATTACH
Farm income or loss. Attach federal Schedule F
13.
13.
W-2 & 1099-R
NOT TAXABLE
14.
Unemployment compensation.
14.
FORMS
Social security benefits.
NOT TAXABLE
15.
15.
HERE
Other income. Attach statement listing type and amount.
16.
16.
Total income. Add lines 1 through 16.
17.
17.
DEDUCTION See instructions. Deductions must be allocated on the same basis as related income.
S
Individual Retirement Account deduction. Attach pg 1 of federal return & evidence of payment
18.
18.
Self-employed SEP, SIMPLE and qualified plans. Attach pg 1 of federal return
19.
19.
Employee business expenses. See instructions
20.
20.
Moving expenses into Springfield only. Attach federal Form 3903
21.
21.
Alimony paid. Do not include child support Attach pg 1 of federal return
22.
22.
Other, explain.
23.
23.
Total deductions. Add lines 18 through 23
24.
24.
Total income after deductions. Subtract line 24 from line 17
25.
25.
Amount from exemptions page 8. Number of exemptions __________ × $750.00
26.
26.
ATTACH
27.
Total income subject to tax. Subtract line 26 from line 25
27.
CHECK
28.
MULTIPLY LINE 27 BY YOUR TAX RATE: RES.= 1% (.01), NONRES.= 1/2% (.005), PART YEAR RES.= 1% (.01) ATTACH SF SCH PY
28.
PAYMENTS AND CREDITS
OR
MONEY
Tax withheld by your employer. W-2 forms showing Springfield tax withheld must be attached
29.
29.
ORDER
Payments on 2009 Declaration of Estimated Income Tax, payments with an extension and carry forward credits.
30.
30.
Credit for tax paid to another city and for tax paid by a partnership.
HERE
31.
31.
Copy of other cities tax return pg 1 must be attached for credit (To figure credit worksheet on page 11)
Total payments and credits. Add lines 29 through 31
32.
32.
TAX DUE
If tax (line 28) is larger than payments (line 32) you owe tax.
PAY WITH RETURN >>>
33.
33.
CREDIT TO 2010
If payments (line 32) are larger than tax (line 28) enter overpayment to be credited forward to 2010
34.
34.
REFUND CHECK
If payments (line 32) are larger than tax (line 28) enter overpayment to be refunded via a refund check
35.
35.
DIRECT DEPOSIT
If payments (line 32) are larger than tax (line 28) enter overpayment to be refunded via direct deposit
36.
36.
(If blank default is date
ELECTRONIC
Mark one:
Refund-direct deposit
Pay tax due-electronic funds withdrawal → Effective date: ___________
_
36 A.
return processed)
REFUND OR PAYMENT
36 B. Routing number:
INFORMATION
36 C. Account number:
36 D. Type of Account:
CHECKING
SAVINGS
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