Fillable 2019 Individual Income Tax Form And Instructions.aspx (City of Highland City)

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2019 Individual Income Tax Form And Instructions.aspx (City of Highland City)

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HP-1040 HIGHLAND PAR
K
Taxpayer's SSN Taxpayer's first name Initial Last name
Nonresident
Spouse's SSN If joint return spouse's first name Initial Last name
From
Present home address (Number and street) Apt. no.
To
FILING STATUS
Address line 2 (P.O. Box address for mailing use only)
City, town or post office State Zip code
Foreign country name Foreign province/county Foreign postal code
Spouse's full name if married filing separately
1. Wages, salaries, tips, etc. ( W-2 forms must be attached) 1
.00 .00 .00
2. Taxable interest 2
.00 .00 .00
3. Ordinary dividends 3
.00 .00 .00
4. Taxable refunds, credits or offsets 4
.00 .00
5. Alimony received 5
.00 .00 .00
6. Business income or (loss) (Attach federal Schedule C) 6
.00 .00 .00
7a. 7
.00 .00 .00
8. Other gains or (losses) (Attach copy of federal Form 4797) 8
.00 .00 .00
9. Taxable IRA distributions 9
.00 .00 .00
10. Taxable pensions and annuities (Attach copy of Form(s) 1099-R) 10
.00 .00 .00
11
.00 .00 .00
12. Subchapter S corporation distributions (Attach federal Sch. K-1) 12
.00 .00
13. Farm income or (loss) (Attach federal Schedule F) 13
.00 .00 .00
14. Unemployment compensation 14
.00 .00
15. Social security benefits 15
.00 .00
16. Other income (Attach statement listing type and amount) 16
.00 .00 .00
17. Total additions (Add lines 2 through 16) 17
.00 .00 .00
18. Total income (Add lines 1 through 16) 18
.00 .00 .00
19. Total deductions (Subtractions) (Total from page 2, Deductions schedule, line 7) 19
.00
20. Total income after deductions (Subtract line 19 from line 18) 20
.00
21a 21b
.00
22. Total income subject to tax (Subtract line 21b from line 20) 22
.00
23a 23b
.00
24. Total payments and credits (Total from page 2, Payments and Credits schedule, line 4) 24
.00
25a
.00
25b
.00
25c
.00
PAY WITH
RETURN
>>>>>
.00
27. Tax overpayment (Subtract lines 23b and 25c from line 24; choose overpayment options on lines 28 - 30) 27
.00
28a 28b 28c 28d
29. Amount of overpayment credited forward to 2020 Amount of credit to 2020 >> 29
.00
Refund amount >> 30
.00
Reserved
MAIL TO: Highland Park Income Tax Dept, P.O. 239 Eaton Rapids, MI 48827-0239
Revised: 12/01/201
Married filing separately. Enter spouse's SSN
in Spouse's SSN box and Spouse's full name
here.
For city use only
Check box if you need a tax
form mailed to you next year.
Part-year resident - dates of residency (mm/dd/yyyy)
Make sure the SSN(s) above and on
page 2, line 1d are correct.
Single Married filing jointly
2019
12MI-HPK1
INDIVIDUAL RETURN DUE APRIL 30, 20
Part-year
resident
Resident
RESIDENCE STATUS
ATTACH
W-2
FORMS
HERE
INCOME
ROUND ALL FIGURES TO NEAREST DOLLAR
($0.50 next dollar)
7.
Capital gain or (loss)
(Attach copy of fed. Sch. D)
Mark if federal
Sch. D not required
Column C
Taxable Income
ATTACH
COPY OF
PAGES OF
FEDERAL
RETURN
NOT TAXABLE
11.
Rental real estate, royalties, partnerships, S corporations, trusts,
etc. (Attach federal Schedule E)
21. Exemptions
(Enter the total exemptions, from Form HP-1040, page 2, box 1h, in line 21a and multiply this
number by $600 and enter on line 21b)
Column A
Federal Return Data
Column B
Exclusions/Adjustments
NOT APPLICABLE
23. Tax
(Multiply line 22 by Highland Park resident tax rate of 2% (0.02) or nonresident tax rate of 1%
(0.01) and enter tax on line 23b, or if using Schedule TC to compute tax, check box 23a and enter
tax from Schedule TC, line 23d)
OVERPAYMENT
28. Reserved
Amount you owe (Add lines 23b and 25c, and subtract line 24)
MAKE CHECK OR MONEY ORDER PAYABLE TO: CITY OF HIGHLAND PARK
ENCLOSE
CHECK OR
MONEY
ORDER
25.
Interest and penalty for: failure to make
estimated tax payments; underpayment
of estimated tax; or late payment of tax
Penalty
Total
interest &
penalty
TAX DUE
26.
Interest
30. Amount of overpayment refunded (Line 27 less line 29)
31. Reserved
31a Not available 31c Reserved
31e
Not available31b 31d Reserved
NOT TAXABLE
NOT TAXABLE
26
Total
donations
Box ,
W94585-NUT01 1/13/15 1:43 PM Page 7
20
9
FIRST 2
19MI-HPK1
Taxpayer's name Taxpayer's SSN
1a. You
1e.
1b. Spouse
1d. List Dependents 1c. Check box if you can be claimed as a dependent on another person's tax return
#
1f.
1
2`
3
1g.
4
5
6
1h.
7
8
EXCLUDED WAGES SCHEDULE (See instructions. Resident wages generally not excludible)
.00 .00 .00 .00
.00 .00 .00 .00
.00 .00 .00 .00
.00 .00 .00 .00
.00 .00 .00 .00
DEDUCTIONS SCHEDULE (See instructions; deductions allocated on same basis as related income)
DEDUCTIONS
1. IRA deduction (Attach copy of page 1 of federal return & evidence of payment) 1
.00
2. Self-employed SEP, SIMPLE and qualified plans (Attach copy of page 1 of federal return) 2
.00
3. Employee business expenses (See instructions and attach copy of federal Form 2106) 3
.00
4. Moving expenses (Into Highland Park area only) (Attach copy of federal Form 3903) 4
.00
5. Alimony paid (DO NOT INCLUDE CHILD SUPPORT. Attach copy of page 1 of federal return) 5
.00
6. Renaissance Zone deduction (Attach Schedule RZ OF 1040) 6
.00
7. Total deductions (Add line 1 through line 6, enter total here and on page 1, line 19) 7
.00
PAYMENTS AND CREDITS SCHEDULE
1. Tax withheld by your employer for HIGHLAND PARK (Attach W-2 Forms showing tax withheld for HIGHLAND PARK, Form W-2, box 19) 1
.00
2. Tax payments other than tax withheld (Estimated income tax payments, extension payment, partnership payments and credit forward) 2
.00
3. Credit for tax paid to another city (Residents attach a copy of other city's return; not allowed for nonresidents) 3
.00
4. Total payments and credits (Add lines 1 through 3, enter total here and on page 1, line 24) 4
.00
ADDRESS SCHEDULE (Where taxpayer (T), spouse (S) or both (B) resided during year and dates of residency)
THIRD PARTY DESIGNEE
Do you want to allow another person to discuss this return with the Income Tax Office? Yes, complete the following No
Designee's Phone
name No.
TAXPAYER'S SIGNATURE - If joint return, both spouses must sign Date (MM/DD/YY) Taxpayer's occupation Daytime phone number If deceased, date of death
SPOUSE'S SIGNATURE Date (MM/DD/YY) Spouse's occupation
If deceased, date of death
SIGNATURE OF PREPARER OTHER THAN TAXPAYER Date (MM/DD/YY) PTIN, EIN or SSN
Preparer's phone no.
FIRM'S NAME (or yours if self-employed), ADDRESS AND ZIP CODE
Revised: 12/01/2019
Personal identification
number (PIN)
Enter the number of
boxes checked on lines
1a and 1b
DisabledDeaf
MONTH
FROM
MONTH DAY
TO
DAY
COLUMN C
RESIDENT EXCLUDED
WAGES
NONRESIDENT EXCLUDED
WAGES
65 or over Date of birth (mm/dd/yyyy)
EMPLOYER'S ID
RESIDENT EXCLUDED
WAGES
NONRESIDENT EXCLUDED
WAGES
9
10
W-2
#
COLUMN A COLUMN B COLUMN C
EMPLOYER'S ID
Under the penalty of perjury, I declare that I have examined this return and 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.
SIGN
HERE
===>
HP-1040, PAGE 2
ADDRESS (INCLUDE CITY, STATE & ZIP CODE) Start with address used on last year's return. If the address is the same as
listed on page 1 of this return, print "Same." If no return filed, list reason. Continue listing residence addresses from this year.
1
2
3
EXEMPTIONS
SCHEDULE
MARK
T, S, B
Regular
COLUMN A COLUMN B
4
5
6
7
W-2
#
8
Total exemptions (Add
lines 1e, 1f and 1g; enter
here and also on page 1,
line 21a)
Blind
First Name Last Name
Social Security Number Relationship Date of Birth
Enter number of other
dependents listed on
line 1d
Enter number of
dependent children listed
on line 1d
PREPARER'S
SIGNATURE
NACTP
software
number
W94585-NUT01 1/13/15 1:43 PM Page 8
19MI-HPK2
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2019 Individual Income Tax Form And Instructions.aspx (City of Highland City)

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Completed 18 July 2020

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