ATTACH A COPY OF THE FRONT OF FEDERAL 1040 FORM
2008
BR 1040
CITY OF BIG RAPIDS INCOME TAX
INDIVIDUAL RETURN
Due Date: April 30, 2009
A. First Name and Initial
Last Name
Your Social Security Number
B. RESIDENCY
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RESIDENT
Inside City Limits
If Joint First Name of Spouse
NON-RESIDENT
Spouse’s Social Security Number
Township of
Big Rapids
Green
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Present Home Address
Colfax
Grant
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Barton
Norwich
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Home
City, State and Zip Code
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Other_______________________
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(Please specify)
D. EXEMPTIONS
C. FILING STATUS
Number______________________x $600.00 = $______________
A. _____ Single
If you are claimed as a dependent on someone else’s Big Rapids return, check
B. _____ Married, Filing Jointly
this box and do not take the exemption.
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C. _____ Married, Filing Separately
If you are a FSU student with permanent home other than Big Rapids, check
Spouse’s Name__________________________________________________
this box and claim yourself.
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Social Security Number __________________________________________
1. INCOME:
See Instructions
A: RESIDENT
00
......................................................................
1.
Attach Copy of Federal Form
B: NON-RESIDENT
Attach Copy of any Federal Schedule(s) that are applicable to your City Return
00
2. ADDITIONS TO INCOME (attach Federal Schedule(s) and Explain) ..........................................................................
2.
00
3. SUBTRACTIONS FROM INCOME (attach Federal Schedule(s) and Explain)..............................................................
3.
00
4. IRA DEDUCTIONS ....................................................................................................................................................
4.
00
5. ADJUSTED INCOME (Add Lines 1 & 2, Subtract 3 & 4)............................................................................................
5.
6. EXEMPTIONS (From D above)
00
..............
6.
(If you are a student and your parents do not file a City of Big Rapids return, check this box
and claim yourself)
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00
7. TAXABLE INCOME (Line 5 less Line 6)......................................................................................................................
7.
8. TAX (Multiply amount on Line 7 by one of the following)
A: RESIDENT - 1% (.01)
00
B: NON-RESIDENT - 1/2% (.005) ................................................................................................................
8.
00
9. VOLUNTARY CONTRIBUTIONS TO BIG RAPIDS COMMUNITY POOL and/or COMMUNITY LIBRARY ..
9.
(Please circle)
00
10. TOTAL OF LINE 8 AND 9........................................................................................................................................
10.
PAYMENTS AND TAX CREDITS
O O F F F F I I C C E E U U S S E E O O N N L L Y Y
00
P P a a y y m m e e n n t t r r e e c c e e i i v v e e d d
11. B
R
T
W
.............................................................................. 11.
IG
APIDS
AX
ITHHELD
w w i i t t h h R R e e t t u u r r n n
00
12. 2008 E
P
............................................................................ 12.
STIMATED
AYMENTS
_____________________
00
13. C
...................................................... 13.
_____________________
REDIT FROM PREVIOUS YEAR OVER PAYMENT
00
14. C
I
T
M
M
(R
O
) .... 14.
_____________________
REDITS FOR
NCOME
AX PAID TO ANOTHER
ICHIGAN
UNICIPALITY
ESIDENTS
NLY
00
15. T
P
C
(Add Lines 11, 12, 13 & 14)........................................................................................
15.
OTAL
AYMENTS AND
REDITS
00
16. TAX DUE (Line 10 larger than Line 15) ....................................................................................................................
16.
00
17. PENALTY AND INTEREST (Schedule 3)..................................................................................................................
17.
00
18. BALANCE DUE (Add Lines 16 and 17) ..................................................................................................................
18.
00
19. OVERPAYMENT (Line 15 is larger than Line 10 ......................................................................................................
19.
Amount on Line 19 is to be (CHECK ONE BOX ONLY)
A.
Credited to 2009
B.
Refunded to You
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I declare, under penalty of perjury, that the information on this return and attachments is true and complete.
I authorize the City to discuss my
DO NOT discuss my
I declare, under penalty of perjury, that this return
claim and attachments with my
claim with my preparer.
is based on all information of which I have knowledge.
preparer
Filer’s Signature ______________________________________________ Date __________________
PREPARER’S SIGNATURE & ADDRESS
Birthdate ______________________________
Spouse’s Signature ____________________________________________ Date __________________
Phone (
)_______________________________
Birthdate ______________________________
MAIL YOUR RETURN FOR REFUND TO: CITY OF BIG RAPIDS, INCOME TAX DIVISION, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307
MAIL YOUR RETURN FOR PAYMENT TO: CITY OF BIG RAPIDS, TREASURER’S OFFICE, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307