CITY OF PORTLAND                                                                     Schedule PY 

PART-YEAR RESIDENT TAX CALCULATION
                             ATTACH THIS SCHEDULE TO YOUR P-1040 FORM
Taxpayer's social security #                       Spouse's social security # 

First Name and Initial                                                         Last Name          

PART-YEAR RESIDENT                    From             To
Taxpayer
Spouse
FORMER ADDRESS
Taxpayer
Spouse
                                                   COMPUTATION OF TAXABLE INCOME
                                                                                                                COLUMN 1              COLUMN 2            
                                                                                                   PORTLAND INCOME  ALL INCOME EARNED PORTLAND INCOME 
 INCOME                                                                                            TAX WITHHELD WHILE A RESIDENT      WHILE A 
                                                                                                                OF PORTLAND           NONRESIDENT
     EMPLOYER'S NAME                                          ADDRESS OF ACTUAL WORK STATION
1.
2.
3.
4.
5.
6.
Total compensation and Portland tax withheld. (Add lines 1 through 6) Enter on line 30 of P-1040.
7. Interest Income
8. Dividend income from federal return.
9a.Business income/loss
9b.Sale and exchange of property.                                                                                                     NOT TAXABLE
9c.Rental Real Estate, Royalties, Partnerships, trust, etc.
9d.Unemployment compensation.                                                                                   NOT TAXABLE           NOT TAXABLE
10.Social security benefits.                                                                                    NOT TAXABLE           NOT TAXABLE
11.Other income.  Attach statement listing type and amount. 
12. Total income.  Add lines 1 through 11.
DEDUCTIONS         See instructions.  Deductions must be allocated on the same basis as related income.
    Individual Retirement Account deduction.          (Attach Schedule 1 of Federal 
13  1040)
14  Employee business expenses              (see instructions and attach detailed list)
15  Moving expenses.  -Into Portland only- See instructions       (ATTACH FEDERAL FORM 3903.)
    Alimony paid.  DO NOT INCLUDE CHILD SUPPORT          (ATTACH  PG 1 2 OF FED. TAX RETURN ALONG WITH THE 
16  NAME, ADDRESS AND SSN OF PERSON YOU ARE PAYING.)
17  Other, explain and attach forms/schedules
18        Total deductions.  Add lines 13 through 17
19        Total income after deductions.  Subtract line 18 from line 12
20  Exemption Amount   (Number of Exemptions,_____times $1000.00)  
21       Total income subject to tax   Subtract line 20 from line 19 
22a Tax at resident rate.    (MULTIPLY LINE 21 BY 1% (.01))
22b Tax at nonresident rate.               (MULTIPLY LINE 19 Column 2 BY 1/2% (.005))
23  Total tax.  Add lines 22a and 22b  (ENTER HERE AND ON PAGE ONE OF THE P-1040, LINE 24)

                                                                                                                                                          Page 8