1998 NR CITY OF GRAND RAPIDS INCOME TAX 1998 NR
INDIVIDUAL RETURN - NONRESIDENT - DUE April 30 1999
Your social security number Your first name Initial Last name Your occupation
Spouse's soc sec number If joint return, spouse's first name Initial Last name Spouse's occupation
OR If married is spouse filing Present home address (Number and street including apartment number)
PRINT a separate return?
YES NO City, town or post office, state and zip code Enter name and address used on 1997
return. If same as above, print "Same."
(If none filed, give reason.)
TO EXEMPTIONS 1a. Yourself 65 or over Blind 1b. Spouse 65 or over Blind Number of boxes checked. 1.
NEAREST 2. List first names of your dependent children who live with you:
DOLLAR Number of children listed. 2.
3. Number of other dependents (Same as federal) GO TO PAGE 2, LINE 22 Number of other dependents. 3.
4. Total number of exemptions - add lines 1, 2, and 3 Total number of exemptions. 4.
5. ENTER ALL WAGES, TIPS AND OTHER COMPENSATION INCLUDING DEFERRED COMPENSATION DISTRIBUTIONS, SICK PAY, ETC.
If you worked for an employer in Grand Rapids only, put total wages in column C. COLUMN A COLUMN B COLUMN C
If you worked in and outside of Grand Rapids for an employer, go to page 2, Line 23. TOTAL WAGES GRAND RAPIDS TAX WAGES ETC. EARNED
EMPLOYER'S NAME LOCATION OF ACTUAL WORK STATION (W-2 FORM, BOX 1) WITHHELD IN GRAND RAPIDS
5a. 5a 00 00 00
5b. 5b 00 00 00
ATTACH 5c. 5c 00 00 00
COPY 5d. 5d 00 00 00
OF 5e. 5e 00 00 00
FORMS 5f. 5f 00 00 00
GRW-2 6. TOTAL COMPENSATION AND TAX WITHHELD - ADD LINES 5a THROUGH 5f 6a 00 6b 00 6c 00
OR 7. Business Income FROM PAGE 2, LINE 24f (ATTACH FEDERAL SCHEDULE C) 7 00
W-2 8. Income from sales and exchanges of tangible property located in Grand Rapids (ATTACH FED SCH D AND FORM 4797)(See instructions) 8 00
HERE 9. Income from rentals, partnerships and other sources FROM PAGE 2, LINE 26f (ATTACH FED. SCH. E, FORMS K-1 AND 8582) 9 00
10. TOTAL INCOME - ADD LINES 6c THROUGH 9 10 00
DEDUCTIONS IF YOU WORKED ONLY IN AND ENTER FULLPUT NOTHING IN COLUMN 1 COLUMN 2 COLUMN 3
COLUMN 1 OR COLUMN 2 AMOUNT IN COLUMN 3 FEDERAL % COL. 1 TIMES
SEE INSTRUCTIONS FOR ADDITIONAL INFORMATION AMOUNT COLUMN 2
11a. IRA deduction (ATTACH PG. 1 OF FED. RETURN & EVIDENCE OF DEPOSIT) 11a %
11b. Employee business expenses (SEE INSTRUCTIONS & ATTACH FED 2106 OR LIST) 11b %
11c. Moving expenses (into Grand Rapids area only) (ATTACH FED. FORM 3903 OR LIST) 11c %
11d. Alimony Paid - DO NOT INCLUDE CHILD SUPPORT (ATTACH PAGE 1 OF FED. RET.) 11d %
11e. Renaissance Zone (ATTACH SCH. RZ) (For individuals and partners with business activity in a Renaissance Zone) 11e
11f. TOTAL DEDUCTIONS - ADD COLUMN 3, LINES 11a THROUGH 11e 11f 00
12. TOTAL INCOME AFTER DEDUCTIONS - SUBTRACT line 11f from line 10 12 * 00
13. LESS: Amount for exemptions - (Number of exemptions from line 4 above ________ X $750) 13 00
ATTACH 14. TOTAL TAXABLE INCOME- income subject to tax - SUBTRACT line 13 from line 12 14 00
CHECK 15. GRAND RAPIDS INCOME TAX - 0.65% (MULTIPLY LINE 14 BY .0065) 15 00
OR PAYMENTS AND CREDITS
MONEY 16a. Tax withheld by your employer from line 6b above (ATTACH W-2 OR GRW-2 FORMS) 16a 00
ORDER 16b. Payments and credits on 1998 Declaration of Estimated Grand Rapids Income Tax 16b 00
HERE 16c. Other credits - EXPLAIN IN ATTACHED STATEMENT 16c 00
17. TOTAL PAYMENTS AND CREDITS - ADD LINES 16a THROUGH 16c 17 00
TAX DUE 18. If tax (line 15) is larger than payments (line 17) YOU OWE TAX - ENTER TAX DUE & PAY WITH RETURN >>> 18 00
OVERPAYMENT 19. If payments (line 17) are larger than tax (line 15) ENTER OVERPAYMENT 19 00
REFUND 20. Amount of overpayment to be MAILED TO YOU 20 00 <<<< REFUND
CREDIT TO 1999 21. Amount of overpayment to be HELD & APPLIED TO YOUR 1999 ESTIMATED TAX 21 00 << CREDIT TO 1999
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 he has any knowledge.
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SIGN TAXPAYER'S SIGNATURE - If joint return, both husband and wife must sign. DATE SIGNATURE OF PREPARER OTHER THAN TAXPAYER DATE
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SPOUSE'S SIGNATURE PHONE NUMBER ( ) - DATE PREPARER'S ADDRESS PHONE NUMBER ( ) -
MAKE CHECK OR MONEY ORDER PAYABLE TO: CITY TREASURER. MAIL TO: CITY INCOME TAX DEPARTMENT, P.O. BOX 2528, GRAND RAPIDS, MI 49501-2528 PAGE 1
Name(s) as shown on GR-1040NR Your social security number
FAILURE TO ATTACH DOCUMENTATION OR ATTACHING INCORRECT OR INCOMPLETE DOCUMENTATION
WILL RESULT IN DEDUCTIONS AND LOSSES BEING DISALLOWED OR DELAY PROCESSING OF RETURN
22. OTHER DEPENDENTS (Same as Federal)
MONTHS OTHER DEPENDENT
NAME OF OTHER DEPENDENT RELATIONSHIP OF OTHER DEPENDENT LIVED IN YOUR HOME
22e. NUMBER OF OTHER DEPENDENTS LISTED ON LINES 22a THROUGH 22d - ENTER HERE AND ON PAGE 1, LINE 3 22e
23. WAGE ALLOCATION
COMPUTATION OF GRAND RAPIDS WAGES OF A NONRESIDENT WHO WORKS BOTH IN AND OUTSIDE OF GRAND RAPIDS FOR THE SAME EMPLOYER.
WAGES FROM LINE 23f ARE TO BE ENTERED ON THE APPROPRIATE LINE OF PAGE 1, LINES 5a THROUGH 5f, COLUMN C, "WAGES, ETC. EARNED IN GRAND RAPIDS."
23a. Employer name (A COMPUTATION MUST BE MADE FOR EACH EMPLOYER) 23a 1. 2. 3. 4.
23 b. Actual number of days or hours worked for employer (DO NOT INCLUDE WEEKENDS
OFF, HOLIDAYS, SICK OR VACATION DAYS, ETC. IN AMOUNTS ON 23b AND 23c) 23b
23c. Actual number of days or hours worked in Grand Rapids 23c
23d. Percentage of days or hours worked in Grand Rapids (line 23c divided by line 23b) 23d % % % %
23e. Total wages shown on GRW-2 or W-2, box 1 23e 00 00 00 00
23f. Wages earned in Grand Rapids (line 23e multiplied by percentage on line 23d) 23f 00 00 00 00
Enter on page 1, lines 5a through 5f, column C, (on the corresponding line for the employer) the Grand Rapids wages from line 23f for each employer .
24. BUSINESS INCOME
24a. Net profit (or loss) from business or profession FROM FEDERAL RETURN (ATTACH FEDERAL SCHEDULE C) 24a 00
24b. Apportionment percentage from line 25g below (IF ALL BUSINESS WAS CONDUCTED IN GRAND RAPIDS ENTER 100%) 24b %
24c. Apportioned income (multiply line 24a by line 24b) 24c 00
24d. Applicable portion of net operating loss carryover (ATTACH SCHEDULE) 24d 00
24e. Applicable portion of retirement plan deduction Check type of plan KEOGH SEP SIMPLE (Attach federal schedule) 24e 00
24f. TOTAL - LINE 24c LESS LINES 24d AND 24e ENTER HERE AND ON PAGE 1, LINE 7 24f 00
25. BUSINESS ALLOCATION PERCENTAGE
COLUMN 1 COLUMN 2 COLUMN 3
LOCATED EVERYWHERE LOCATED IN GRAND RAPIDS PERCENTAGE
25a. Average net book value of real and tangible personal property 25a (COLUMN 2 DIVIDED
25b. Gross rents paid on real property multiplied by 8 25b BY COLUMN 1)
25c. Total property (Add lines 25a and 25b) 25c %
25d. Total wages, salaries and other compensation of all employees 25d %
25e. Gross receipts from sales made or services rendered 25e %
25f. Total percentages (Add the percentages computed in column 3 lines 25c, 25d and 25e) 25f %
25g. Business Allocation Percentage (Divide line 25f by the number of factors used) Enter here and on line 24b above 25g %
26. RENTAL, PARTNERSHIP AND OTHER INCOME
GRAND RAPIDS INCOME (OR LOSS) FROM RENTALS, PARTNERSHIPS, PROFIT SHARING DISTRIBUTIONS, PREMATURE I.R.A. DISTRIBUTIONS, PREMATURE
PENSION DISTRIBUTIONS, ETC. ATTACH COPIES OF FED. SCH. E, FED. FORM 8582, FED. K-1, FED. FORM 1099 AND OTHER APPLICABLE SCHEDULES.
RECEIVED FROM KIND OF INCOME ADDRESS FEDERAL I. D. NUMBER AMOUNT
26a. 26a 00
26b. 26b 00
26c. 26c 00
26d. 26d 00
26e. 26e 00
26f. TOTAL - ADD LINES 26a through 26e ENTER HERE AND ON PAGE 1, LINE 9 26f 00
1998 GR-1040NR PAGE 2