L-1040                                                          LANSING                                                                 2020                                                    20MI-LNS1-1040-1
                                                                INDIVIDUAL RETURN DUE APRIL 30, 2021
Taxpayer's SSN                                                     Taxpayer's first name                           Initial Last name                                                    RESIDENCE STATUS
                                                                                                                                                                                          Resident        Nonresident               Part-year
                                                                                                                                                                                                                                    resident
Spouse's SSN                                                       If joint return spouse's first name             Initial Last name                                                  Part-year resident - dates of residency (mm/dd/yyyy)
                                                                                                                                                                                      From
Mark (X) box if  deceased                                          Present home address (Number and street)                                            Apt. no.                       To
Taxpayer                                                    Spouse                                                                                                                      FILING STATUS
Enter date of death on page 2, right side  Address line 2 (P.O. Box address for mailing use only)                                                                                         Single          Married filing jointly
of the signature area
                                                                                                                                                                                          Married filing separately. Enter spouse's 
Mark box (X) below if:                                             City, town or post office                                        State    Zip code                                     SSN in Spouse's SSN box and Spouse's full 
Federal Form 1310 attached                                                                                                                                                                name here.   
                                                                   Foreign country name                  Foreign province/county             Foreign postal code
Itemized deductions on your                                                                                                                                                             Spouse's full name if married filing separately
Federal tax return for 2020
                                                            ROUND ALL FIGURES TO NEAREST DOLLAR
          INCOME                                                (Drop amounts under $0.50 and increase                               Column A                                      Column B                Column C
                                                                amounts from $.50 to $0.99 to next dollar)                         Federal Return Data       Exclusions/Adjustments                       Taxable Income
ATTACH   1.                Wages, salaries, tips, etc. ( W-2 forms must be attached)                                 1                                 .00                                         .00                                 .00
COPY OF  2.                Taxable interest                                                                          2                                 .00                                         .00                                 .00
         3.                Ordinary dividends                                                                        3                                 .00                                         .00                                 .00
PAGE     4.                Taxable refunds, credits or offsets of state and local income taxes 4                                                       .00                                         .00    NOT TAXABLE
1 - 2    5.                Alimony received                                                                          5                                 .00                                         .00                                 .00
AND      6.                Business income or (loss) (Attach copy of federal Schedule C)                             6                                 .00                                         .00                                 .00
         7.                Capital gain or (loss)
SCHEDULE                   (Attach copy of fed. Sch. D)            7a.                            Mark if federal    7                                 .00                                         .00                                 .00
 1                                                                                                Sch. D not required
 OF      8.                Other gains or (losses) (Attach copy of federal Form 4797)                                8                                 .00                                         .00                                 .00
         9.                Taxable IRA distributions (Attach copy of Form(s) 1099-R)                                 9                                 .00                                         .00                                 .00
 FEDERAL 
RETURNS 10. Taxable pensions and annuities (Attach copy of Form(s) 1099-R) 10                                                                          .00                                         .00                                 .00
         11.               Rental real estate, royalties, partnerships, S corporations, 
                           trusts, etc. (Attach copy of federal Schedule E)                                        11                                  .00                                         .00                                 .00
         12. Subchapter S corporation distributions  (Attach federal Sch. K-1) 12                                                  NOT APPLICABLE                                                  .00                                 .00
ATTACH   13. Farm income or (loss) (Attach copy of federal Schedule F)                                             13                                  .00                                         .00                                 .00
W-2      14. Unemployment compensation                                                                             14                                  .00                                         .00    NOT TAXABLE
FORMS    15. Social security benefits                                                                              15                                  .00                                         .00    NOT TAXABLE
HERE
         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
         21. Exemptions                                         (Enter the total exemptions, from Form L-1040, page 2, box 1h, in line 21a and multiply this 
                                                                number by $600 and enter on line 21b)                                                                             21a              21b                                 .00
         22.                                                Total income subject to tax (Subtract line 21b from line 20)                                                                           22                                  .00
                                                                (Multiply line 22 by Lansing resident tax rate of 1.% (0.01) or nonresident tax rate of 0.5% (0.005) 
         23. Tax at {tax rate}                                  and enter tax on line 23b, or if using Schedule TC to compute tax, check box 23a and enter tax 
                                                                from Schedule TC, line 23c)                                                                                       23a              23b                                 .00
                           Payments                                 Lansing tax withheld             Other tax payments (est, extension,
         24. and                                                                                     cr fwd, partnership & tax option corp)    Credit for tax paidto another city       Total 
                                                                                                                                                                                        payments  
                           credits                          24a         .00                          24b                           .00  24c                                       .00   & credits     24d                              .00
         25.               Interest and penalty for: failure to make                                                      Interest                      Penalty                         Total  
                           estimated tax payments; underpayment of                                                                                                                      interest & 
                           estimated tax; or late payment of tax                                     25a                           .00  25b                                       .00   penalty    25c                                 .00
ENCLOSE                                                         Amount you owe (Add lines 23b and 25c, and subtract line 24)                                                          PAY WITH
CHECK OR TAX DUE                                            26.                                                                                                                                    26
                                                                MAKE CHECK OR MONEY ORDER PAYABLE TO: CITY OF LANSING      
MONEY                                                           IF PAID ON LINE CREDITCARD/ELECTRONIC CHECK ENTER CONF #                                                              RETURN                                           .00
ORDER    OVERPAYMENT                                               27.  Tax overpayment (Subtract lines 23b and 25c from line 24d; choose overpayment options on lines 28 - 30) 27                                                     .00
                           Amount of                               Police Problem Solving                          Hope Scholarship           Homeless Assistance
         28. overpayment                                                                                                                                                                Total 
                           donated                          28a         .00                          28b                           .00  28c                                       .00   donations  28d                                 .00
         29.  Amount of overpayment credited forward to 2021                                                                                                    Amount of credit to 2021   29                                          .00
         30.               Amount of overpayment refunded (Line 27 less lines 28d and 29) (For refund to be directly deposited to   
                           your bank account, mark refund box, line 31a, and complete line 31 c, d & e)                                                                           Refund amount >>  30                                 .00
                           Direct deposit refund  or               31a  Refund                                      31c   Routing 
                           Direct withdrawal payment                    (direct deposit)                                  number
                                                                        Pay Tax Due
         31. (Mark (X) box 31aandor 31b complete lines 31c,        31b  (direct withdrawal)                        31d    Account 
                                                                                                                          number
                           31d, and 31e)                                                                           31e    Account Type:        Checking                            Savings
MAIL REFUND AND CREDIT FORWARD RETURNS TO: LANSING INCOME TAX DEPARTMENT, PO BOX 40750, LANSING, MI  48901                                                                                                Revised: 12/8/20
MAIL TAX DUE AND NO REFUND NO TAX DUE RETURNS TO: LANSING INCOME TAX DEPARTMENT, PO BOX 40752, LANSING, MI  48901

                                                                               Taxpayer's name                                                                                                 Taxpayer's SSN
L-1040, PAGE 2                                                                                                                                                                                                                                                    20MI-LNS-1040-2
                                                                                                                                                                                                                                                                    c
EXEMPTIONS                                                                       Date of birth (mm/dd/yyyy)                                                      Regular  65 or over           Blind          Deaf Disabled
                                                                    1a. You                                                                                                                                                                                       1e. Enter the number of  
SCHEDULE                                                                                                                                                                                                                                                              boxes checked on  lines 
                                                                    1b. Spouse                                                                                                                                                                                        1a and 1b
1d.                     List Dependents                             1c.         Check box if you can be claimed as a dependent on another person's tax return
#                                 First Name                                   Last Name                              Social Security Number                             Relationship                          Date of Birth                                      1f. Enter number of 
1                                                                                                                                                                                                                                                                     dependent children 
                                                                                                                                                                                                                                                                      listed on line 1d 
2.                                                                                        `
3.                                                                                                                                                                                                                                                                1g. Enter number of other 
                                                                                                                                                                                                                                                                      dependents listed on   
4.                                                                                                                                                                                                                                                                    line 1d 
5.
6.                                                                                                                                                                                                                                                                1h. Total exemptions (Add 
                                                                                                                                                                                                                                                                      lines 1e, 1f and 1g; enter 
7.                                                                                                                                                                                                                                                                    here and also on page 1, 
8.                                                                                                                                                                                                                                                                    line 21a)      
EXCLUDED WAGES AND TAX WITHHELD SCHEDULE (See instructions. Resident wages generally not excluded) 
W-2                     Col. A                                       COLUMN B                        COLUMN C                                                   COLUMN D                                                                               COLUMN E                   LOCALITY NAME     COLUMN F
#                       T or S    SOCIAL SECURITY NUMBER (Form W-2, box a)     EMPLOYER'S ID NUMBER                    (Attach ExcludedEXCLUDED WAGESWages Sch)                                    FAILURE TO      LANSING TAX WITHHELD(Form W-2, box 19)                         (Form W-2, box 20)
                                                                                                    (Form W-2, box b)                                                                              ATTACH W-2 
 1.                                                                                                                                                                      .00                   FORMS TO PAGE                                                          .00
 2.                                                                                                                                                                      .00                       1 WILL DELAY                                                       .00
 3.                                                                                                                                                                      .00                   PROCESSING OF                                                          .00
                                                                                                                                                                                                   RETURN.  WAGE 
 4.                                                                                                                                                                      .00                       INFORMATION                                                        .00
 5.                                                                                                                                                                      .00                       STATEMENTS                                                         .00
 6.                                                                                                                                                                      .00                       PRINTED FROM                                                       .00
                                                                                                                                                                                                           TAX 
 7.                                                                                                                                                                      .00                       PREPARATION                                                        .00
 8.                                                                                                                                                                      .00                       SOFTWARE ARE                                                       .00
 9.                                                                                                                                                                      .00                               NOT                                                        .00
                                                                                                                                                                                                   ACCEPTABLE.
10.                                                                                                                                                                      .00                                                                                          .00
11.                     Totals (Enter here and on page 1; part-yr residents on Sch TC)                                                                                   .00 << Enter on pg 1,ln 1, col B                                                             .00     Enter on pg 1, ln 24a
DEDUCTIONS SCHEDULE (See instructions; deductions allocated on the same basis as related income)                                                                                                                                                                       DEDUCTIONS
 1.                     IRA deduction  (Attach copy of Schedule 1 of Federal return and evidence of payment)                                                                                                                                                    1                                                   .00
 2.                     Self-employed SEP, SIMPLE and qualified plans  (Attach copy of Schedule 1 of federal return)                                                                                                                                            2                                                   .00
 3.                     Employee business expenses  (See instructions and attach copy of Detailed Log of Expenses)                                                                                                                                              3                                                   .00
 4.                     Moving expenses for members of Armed Forces ONLY (Into Lansing area only)  (Attach copy of federal Form 3903)                                                                                                                           4                                                   .00
 5.                     Alimony paid  (DO NOT INCLUDE CHILD SUPPORT.  Attach copy of Schedule 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
ADDRESS SCHEDULE (Where taxpayer (T), spouse (S) or both (B) resided during year and dates of residency)
MARK                              List all residence (domicile) addresses (Include city, state & zip code). Start with address used on last year's return. If the address on page 1 of                                                                                FROM                                  TO
                                  this return is the same as listed on last year's return, print "Same." If no return filed last year, list reason. Continue listing this tax year's residence 
T, S, B                           addresses. If address listed on page 1 of this return is in care of another person, enter current residence (domicile) address.                                                                                                 MONTH       DAY                          MONTH    DAY

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                                                      Personal identification 
name                                                                                                                                                                                           No.                                                        number (PIN)
                                  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                              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 
HERE 
===>
                                  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                                                                                                                                                           NACTP  
            PREPARER'S  SIGNATURE                                                                                                                                                                                                                         software  
                                                                                                                                                                                                                                                          number 
                                                                                                                                                                                                                                                                                                    Revised: 12/8/20

Taxpayer's name                                                     Taxpayer's SSN
                                                                                                                   2020 LANSING
SCHEDULE TC, PART-YEAR RESIDENT TAX CALCULATION -  L-1040, PAGE 1, LINES 23a AND 23b                                                                  Attachment 1
A part-year resident is required to complete and attach this schedule to the Lansing return:                                                          Revised 12/8/20
1. Box A to report dates of residency of the taxpayer and spouse during the tax year
2. Box B to report the former address of the taxpayer and spouse 
3. Column A to report all income from their federal income tax return 
4. Column B to report all income taxable on their federal return that is not taxable to Lansing 
5. Column C to report income taxable as a resident and compute tax due on this income at the resident tax rate 
6. Column D to report income taxable as a nonresident and compute tax due on this income at the nonresident tax rate 
A. PART-YEAR RESIDENCY PERIOD                                 From          To                 B. PART-YEAR RESIDENT'S FORMER ADDRESS
Taxpayer                                                                                       Taxpayer
Spouse                                                                                         Spouse
                                                                    Column A                   Column B                          Column C             Column D  
INCOME                                                             Federal Return Data         Exclusions and Adjustments        Taxable              Taxable
                                                                                                                                 Resident Income      Nonresident Income  
1. Wages, salaries, tips, etc. (Attach Form(s) W-2)        1                           .00                         .00                            .00                     .00
2. Taxable interest                                        2                           .00                         .00                            .00 NOT TAXABLE
3. Ordinary dividends                                      3                           .00                         .00                            .00 NOT TAXABLE
4. Taxable refunds, credits or offsets                     4                           .00                         .00           NOT APPLICABLE       NOT TAXABLE
5. Alimony received                                        5                                                       .00                            .00                     .00
6. Business income or (loss) (Att. copy of fed. Sch. C)    6                           .00                         .00                            .00                     .00
                                       Mark if Sch. 
7. Capital gain or (loss)  7a          D not               7b                          .00                         .00                            .00                     .00
    (Att. copy of Sch. D)              required
8. Other gains or (losses)  (Att. copy of Form 4797)       8                           .00                         .00                            .00                     .00
9. Taxable IRA distributions                               9                           .00                         .00                            .00                     .00
10. Taxable pensions and annuities  (Att. Form 1099-R) 10                              .00                         .00                            .00                     .00
11. Rental real estate, royalties, partnerships, S corps., 11                          .00                         .00                            .00                     .00
    trusts, etc. (Attach copy of fed. Sch. E)
    Subchapter S corporation distributions  
12. (Attach federal Sch. K-1)                              12                          .00                         .00                            .00                     .00
13. Farm income or (loss)  (Att. copy of fed. Sch. F)      13                          .00                         .00                            .00                     .00
14. Unemployment compensation                              14                          .00                         .00           NOT APPLICABLE       NOT TAXABLE
15. Social security benefits                               15                          .00                         .00           NOT APPLICABLE       NOT TAXABLE
16. Other income (Att. statement listing type and amt)     16                          .00                         .00                            .00                     .00
17.   Total additions  (Add lines 2 through 16)            17                          .00                         .00                            .00                     .00
18.   Total income (Add lines 1 through 16)                18                          .00                         .00                            .00                     .00
DEDUCTIONS SCHEDULE                          See instructions.  Deductions must be allocated on the same basis as related income.
      1. IRA deduction (Attach copy of schedule 1          1                           .00                         .00                            .00                     .00
      of federal return & evidence of payment)
      Self-employed  SEP,  SIMPLE  and  qualified 
      2. plans (Att. copy of schedule 1 of fed. return)    2                           .00                         .00                            .00                     .00
      Employee business expenses (See 
      3. instructions & attach copy of detailed log of     3                                                                                      .00                     .00
      expenses)
      Moving expenses - ARMED FORCES ONLY 
      4. (into Lansing area only)  (Att copy of federal    4                           .00                         .00                            .00                     .00
      Form 3903)
      Alimony paid  (DO NOT INCLUDE 
      5. CHILD SUPPORT. (Attach copy of                    5                           .00                         .00                            .00                     .00
      schedule 1 of federal return)
      6. Renaissance Zone deduction (Att. Sch. RZ)         6                                                                                      .00                     .00
19.   Total deductions (Add lines 1 through 6)                                                                     19                             .00                     .00
 20a. Total income after deductions (Subtract line 19 from line 18)                                                20a                            .00                     .00
 20b. Losses transferred between columns C and D (If line 20a is a loss in either column C or D, see instructions) 20b                            .00                     .00
 20c. Total income after adjustment (Line 20a less line 20b)                                                       20c                            .00                     .00
21. Exemptions  (Enter the number of exemptions from Form L-1040, page 2, box 1h, on line 21a;                21a  21b                            .00
                multiply line 21a by $600; and enter the result on line 21b)
                (If the amount on line 21b exceeds the amount of resident income on line 20c, 
                enter unused portion (line 21b less line 20c) on line 21c)                                         21c                                                    .00
 22a. Total income subject to tax as a resident (Subtract line 21b from line 20c; if zero or less,enter zero)      22a                            .00
 22b. Total income subject to tax as a nonresident (Subtract line 21c from line 20c; if zero or less,enter zero)   22b                                                    .00
 23a. Tax at resident rate                   (MULTIPLY LINE 22a BY 1.% (0.01), THE RESIDENT TAX RATE)              23a                            .00
 23b. Tax at nonresident rate                (MULTIPLY LINE 22b BY 0.5% (0.005), THE NONRESIDENT TAX RATE)         23b                                                    .00
                                             (ENTER HERE AND ON FORM L-1040, PAGE 1, LINE 23b, AND 
 23c. Total tax (Add lines 23a and 23b)      PLACE A MARK (X) IN BOX 23a OF FORM L-1040)                           23c                            .00

Taxpayer's name                                                Taxpayer's SSN
                                                                                                                     2020 LANSING
WAGES AND EXCLUDIBLE WAGES SCHEDULE - L-1040, PAGE 1, LINE 1, COLUMN B                                                                                       Attachment 2-1
                                                                                                                                                             Revised 12/8/20
All W-2 forms must be attached to page 1 of the return
Use this form to provide details for all Forms W-2 and all other wage income reported on federal form 1040, line 7, such as: wages received as a household employee for which you did not receive a 
W-2; tips reported on federal Form 4137; taxable dependent care benefits; employer-provided adoption benefits; scholarship and fellowship grants not reported on Form W-2; disability pensions 
shown on Form 1099-R if the taxpayer has not reached the minimum retirement age set by the employer; corrective distributions from a retirement plan shown on Form 1099-R from excess salary 
deferrals and/or excess contributions (plus earnings); wages from Form 8919, line 6; and other wage items not included in a Form W-2.
Use this form to calculate excludible (nontaxable) wages included in total wages reported on your federal tax return form 1040, line 7. Excludible wages for each employer are also reported on Form 
L-1040, page 2, Excluded Wages and Tax Withheld Schedule and the total amount of excludible wages is reported on Form L-1040, page 1, line 1, column B. 
WAGES, ETC.                                        Employer (or source) 1                 Employer (or source) 2                                             Employer (or source) 3
1. Employer's ID number (W-2, box b) or 
source's ID Number if available
2. Employer's name (Form W-2, box c) or 
source's name
3. SSN from Form W-2, box a
4. Enter T for taxpayer or S for spouse 
5. Dates of employment during tax year        From          To                       From                            To                             From     To
6. Mark (X) box If you work at multiple 
locations in and out of the Lansing
7. Address of work station (Where you 
actually work, not address on Form W-2 
unless you work there: include street 
number and street name, city, state and 
ZIP code; if line 6 is checked enter     
primary work location)
8. Wages, tips, other compensation   
(Form W-2, Box 1)
9. Wages not included in Form W-2, box 1 
(See instructions)
10. Code for wage type reported on line 9 
NONRESIDENT WAGE ALLOCATION                        Employer (or source) 1                 Employer (or source) 2                                             Employer (or source) 3
For use by nonresidents or part-year residents who worked both in and outside of the Lansing for the employer while a nonresident. Part-year residents working both in and outside while a nonresident 
must use the wage allocation to determine wages earned in Lansing while a nonresident (use only wages and days worked while a nonresident for computations). Nonresidents working all of their 
work time for an employer in the Lansing should skip this Nonresident Wage Allocation section for that employer as all of their wages are taxable.
11. Enter actual number of days or hours on 
job for employer during period (Do not 
include weekends you did not work)
12. Vacation, holiday and sick days or hours 
included in line 11, only if work performed 
in and outside of Lansing
13. Actual number of days or hours worked 
(Line 11 less line 12)
14. Enter actual number of days or hours 
worked in Lansing
15. Percentage of days or hours 
worked in Lansing (Line 14 divided by                                              %                                                              %                                            %
line 13; default is 100%)
16. Wages earned in Lansing (Total of lines 8 
and 9 multiplied by line 15; part-year 
residents use only the portion of wages 
earned while a nonresident) 
EXCLUDIBLE WAGES                                   Employer (or source) 1                 Employer (or source) 2                                             Employer (or source) 3
17. Enter nonresident excludible wages (Total 
of lines 8 & 9 less line 16) 
18. Enter resident excludible wages 
19. Enter reason excludible wages reported on 
lines 17 and/or 18 are not taxable by 
Lansing
20. Total excludible wages (Line 17 plus line 
18; Enter here and  on  L-1040, page 2, 
Excluded Wages schedule)
21. Total taxable wages (Line 8 plus line 9  
less line 20)
22. Total wages (Add lines 8 and 9 for all employers and other sources; must equal 
amount reported on Form L-1040, page 1, line 1, column A; Part-year residents 
must equal amount reported on Schedule TC, line 1, column A)
23. Total excludible wages from all employers and other sources (Add line 20 for all columns; enter here and also on 
Form L-1040, page 1, line 1, column B; part-year residents enter here and on Schedule TC, line 1, column B))
24. Total taxable wages from all employers and other sources (Line 22 less line 23); enter here and also on Form L-1040, page 1, line 1, column C; part-year 
residents enter here and allocate on Schedule TC, line 1, between columns C and D)

FAILURE TO ATTACH ALL FORMS W-2 OR PROPERLY COMPLETE AND ATTACH THIS SCHEDULE WILL DELAY PROCESSING OF RETURN. 

L-1040PV                                                                LANSING                                              2020  RET RPV
                                                              INCOME TAX RETURN PAYMENT VOUCHER

Taxpayer Name:

Social Security No:

Due on or Before:                         4/30/2021, due date of 2020 return*

Payment:                                  $

Payment Method:                           Make payment by check or money order payable to "City of Lansing." Include your social security 
                                          number, daytime phone number, and "2020 L-1040PV" on your check or money order. DO NOT 
                                          SEND CASH. To pay by credit card or direct debit, see income tax website of the City of Lansing. Not 
                                          all cities accept credit card or direct debit payments.  

Paying with Return:                       This payment voucher is not used when including payment with your tax return. When paying with your 
                                          return, place the payment on top of the return in the envelope. Do not attach the check to the return.

Address for Payment:                      City of Lansing Income Tax Department
                                          PO Box 40752 
                                          Lansing, MI  48901

* Due Date If the due date falls on a Saturday, Sunday or holiday, the due date is the next business day.

Taxpayer Records:                         Amount Paid: 
                                          Check Number:
                                          Date Mailed: 

        KEEP TOP PORTION FOR YOUR RECORDS.  SEND BOTTOM PORTION WITH YOUR PAYMENT 
                                                                       v   DETACH HERE  v
                                                                                                                             Revised: 12/8/20
                                                                        LANSING
L-1040PV                                                      INCOME TAX RETURN PAYMENT VOUCHER                              2020  RET RPV
                                                                       Mail To: Lansing Income Tax Department
                                                                        PO Box 40752
NACTP #                                                                 Lansing, MI 48901
EFIN #
Taxpayer's first name, initial, last name                              Taxpayer's SSN

If joint return spouse's first name, initial, last name                If joint payment, spouse's SSN

Present home address (Number and street)                      Apt. no. {2D Barcode of scan line data}

Address line 2 (P.O. Box address for mailing use only)

City, town or post office                               State Zip code

Foreign country name, province/county, postal code                     Amount of tax, interest and penalty you are paying by Round to nearest dollar
                                                                       check or money order                                                         .00

WITHHOLDING TAX CREDITS AND OTHER CREDITS (Line 5)
A. WITHHOLDING TAX CREDITS: You may subtract from your estimated Lansing Income Tax (Line 4), the
   amount of Lansing income tax expected to be withheld.

B. INCOME TAX PAID TO ANOTHER CITY: If you are a resident of Lansing and pay income tax to another city on
   income earned outside of Lansing you may subtract from your estimate of Lansing income tax the amount of income
   tax expected to be paid to the other city. This credit may not exceed the amount of tax assessable under the
   Lansing Income Tax Ordinance on the same amount of income of a non-resident. (Worksheet Line 6)

C. INCOME TAX PAID BY PARTNERSHIPS: If you are a member of a partnership which elects to file a return and pay the
   tax on behalf of the partners, you may subtract, from your estimate of Lansing Income Tax, the amount of tax
   expected to be paid by the partnership for your distributive share of net profits. (Worksheet Line 6)

AMENDED  ESTIMATED  TAX:  if  you have filed  an estimated tax  voucher  and find that  your  estimated tax  is
substantially increased or decreased as a result of a change in your income or exemptions, you may amend your 
estimate at the time of making a quarterly payment:. 

PENALTIES AND INTEREST: If the total amount of tax withheld and estimated tax paid is less than seventy percent
(70%) of the final tax due, interest and penalties may be charged. 
FORMS OR INFORMATION: Forms or information may be obtained in 3 ways. 
   1. Visit our website at www.lansingmi.gov
                                                             st
   2. Visit us at the Income Tax Department located on 1  floor City Hall.
   3. Phone us at (517) 483-4114.

NOTE: FILING ESTIMATED TAX DOES NOT EXCUSE THE TAXPAYER FROM FILING AN ANNUAL RETURN 
EVEN THOUGH THERE IS NO CHANGE IN THE ESTIMATED TAX LIABILITY. 

   *If the due date falls on a Saturday, Sunday or legal holiday, the due date is extended to the next
   day which is not a Saturday, Sunday or legal holiday.

WORKSHEET FOR 2021 ESTIMATED INCOME TAX

   (KEEP FOR YOUR RECORDS)                                                                            2021 PAYMENT RECORD
1. TOTAL LANSING INCOME EXPECTED IN 2021                   $        VOUCHER                             DATE  CHECK     TAX 
   (See Instructions)                                                                                   NUMBER          PAID 
2. EXEMPTIONS ($600 for each exemption; Does not           $                                          1             $ 
   apply to corporations)
3. ESTIMATED LANSING TAXABLE INCOME                        $                                          2               $ 
   (Line 1 less Line 2)
4 . ESTIMATED LANSING INCOME TAX BEFORE                                                                               $ 
   CREDITS (Non-resident individuals enter . 5% of Line 3, $                                          3 
   All other taxpayers enter 1.0% of Line 3) 
                                                                                                                      $ 
5. AMOUNT OF LANSING TAX TO BE WITHHELD                    $                                          4 

6. AMOUNT OF OTHER CREDITS                                 $       TOTAL PAID                                       $ 
7. ESTIMATED LANSING INCOME TAX DUE
   (Line 4 less Lines 5 and 6)                             $ 

L-1040ES                                                                   LANSING                                                    2021  EST 01Q
                                                        ESTIMATED INCOME TAX PAYMENT VOUCHER 
                                                        FIRST QUARTER - PAYMENT DUE APRIL 30, 2021

Taxpayer Name:

Social Security No:

Due on or Before:                         4/30/2021, for tax year 2021*

Payment:                                  $
                                          Make payment by check or money order payable to "City of Lansing." Write your social security number, 
Payment Method:                           daytime phone number, and "2021 L-1040ES" on your check or money order. DO NOT SEND CASH. To pay 
                                          by credit card or direct debit, see income tax website of the City of Lansing. Not all  
                                          cities accept credit card or direct debit payments.  

                                          The spouse of the joint filing taxpayer may use this payment voucher to make estimated income tax 
Additional Information:                   payments under his or her own social security number by listing their name and social security number as the 
                                          taxpayer on this payment voucher.

Address for Payment:                      City of Lansing Income Tax Department
                                          PO Box 40756 
                                          Lansing, MI  48901

* Due Date If the due date falls on a Saturday, Sunday or holiday, the due date is the next business day.

Taxpayer Records:                         Amount Paid: 
                                          Check Number:
                                          Date Mailed: 

         KEEP TOP PORTION FOR YOUR RECORDS.  SEND BOTTOM PORTION WITH YOUR 
                                                                       PAYMENT v   DETACH HERE  v                                     Revised: 12/8/20
                                                                                                                                      Revised: 12/8/20
                                                                           LANSING
L-1040ES                                   FIRST QUARTER ESTIMATED INCOME TAX PAYMENT VOUCHER                                         2021  EST 01Q
                                                                      Mail To: Lansing Income Tax Department
                                                                       PO Box 40756
NACTP #                                                                Lansing, MI 48901
EFIN #                                                                 ESTIMATED PAYMENT VOUCHER 1                                    Due Date:  04/30/2021
Taxpayer's first name, initial, last name                              Taxpayer's SSN

If joint return spouse's first name, initial, last name                If joint payment, spouse's SSN

Present home address (Number and street)                      Apt. no. {2D Barcode of scan line data}

Address line 2 (P.O. Box address for mailing use only)

City, town or post office                               State Zip code

Foreign country name, province/county, postal code                     Amount of estimated tax you are paying by check or money order Round to nearest dollar
                                                                                                                                                             .00

L-1040ES                                                                LANSING                                                       2021 EST 02Q
                                                        ESTIMATED INCOME TAX PAYMENT VOUCHER SECOND 
                                                              QUARTER - PAYMENT DUE JUNE 30, 2021

Taxpayer Name:

Social Security No:

Due on or Before:                         6/30/2021, for tax year 2021*

Payment:                                  $

Payment Method:                           Make payment by check or money order payable to "City of Lansing." Write your social security number, 
                                          daytime phone number, and "2021 L-1040ES" on your check or money order. DO NOT SEND CASH. To 
                                          pay by credit card or direct debit, see income tax website of the City of Lansing. Not all  
                                          cities accept credit card or direct debit payments.  

Additional Information:                   The spouse of the joint filing taxpayer may use this payment voucher to make estimated income tax 
                                          payments under  his or her own social security number by listing their name and social security number as 
                                          the taxpayer on    this payment   voucher.

Address for Payment:                      City of Lansing Income Tax Department
                                          PO Box 40756 
                                          Lansing, MI  48901

* Due Date If the due date falls on a Saturday, Sunday or holiday, the due date is the next business day.

Taxpayer Records:                         Amount Paid: 
                                          Check Number:
                                          Date Mailed: 

                                                                                                                                      Revised: 12/8/20
        KEEP TOP PORTION FOR YOUR RECORDS.  SEND BOTTOM PORTION WITH YOUR PAYMENT 
                                                                       v   DETACH HERE  v
                                                                        LANSING                                                       Revised: 12/8/20
L-1040ES                                   SECOND QUARTER ESTIMATED INCOME TAX PAYMENT VOUCHER                                        2021  EST 02Q
                                                                      Mail To: Lansing Income Tax Department
                                                                        PO Box 40756
NACTP #                                                                 Lansing, MI 48901
EFIN #                                                                 ESTIMATED PAYMENT VOUCHER 2                                    Due Date:  06/30/2021
Taxpayer's first name, initial, last name                              Taxpayer's SSN

If joint return spouse's first name, initial, last name                If joint payment, spouse's SSN

Present home address (Number and street)                      Apt. no. {2D Barcode of scan line data}

Address line 2 (P.O. Box address for mailing use only)

City, town or post office                               State Zip code

Foreign country name, province/county, postal code                     Amount of estimated tax you are paying by check or money order Round to nearest dollar
                                                                                                                                                             .00

L-1040ES                                                                LANSING                                                       2021  EST 03Q
                                                        ESTIMATED INCOME TAX PAYMENT VOUCHER
                                           THIRD QUARTER - PAYMENT DUE SEPTEMBER 30, 2021

Taxpayer Name:

Social Security No:

Due on or Before:                         9/30/2021, for tax year 2021*

Payment:                                  $

Payment Method:                           Make payment by check or money order payable to "City of Lansing." Write your social security number, 
                                          daytime phone number, and "2021 L-1040ES" on your check or money order. DO NOT SEND CASH. To 
                                          pay by credit card or direct debit, see income tax website of the City of Lansing. Not all  
                                          cities accept credit card or direct debit payments.  

Additional Information:                   The spouse of the joint filing taxpayer may use this payment voucher to make estimated income tax 
                                          payments under his or her own social security number by listing their name and social security number as 
                                          the taxpayer on this   payment   voucher. 

Address for Payment:                      City of Lansing Income Tax Department
                                          PO Box 40756 
                                          Lansing, MI  48901

* Due Date If the due date falls on a Saturday, Sunday or holiday, the due date is the next business day.

Taxpayer Records:                         Amount Paid: 
                                          Check Number:
                                          Date Mailed: 

                                                                                                                                      Revised: 12/8/20
        KEEP TOP PORTION FOR YOUR RECORDS.  SEND BOTTOM PORTION WITH YOUR PAYMENT 
                                                                       v   DETACH HERE  v
                                                                                                                                      Revised: 12/8/20
                                                                        LANSING 
L-1040ES                                   THIRD QUARTER ESTIMATED INCOME TAX PAYMENT VOUCHER                                         2021  EST 03Q
                                                              Mail To: Lansing Income Tax Department
                                                                        PO Box 40756
NACTP #                                                                Lansing, MI 48901
EFIN #                                                                 ESTIMATED PAYMENT VOUCHER 3                                    Due Date:  09/30/2021
Taxpayer's first name, initial, last name                              Taxpayer's SSN

If joint return spouse's first name, initial, last name                If joint payment, spouse's SSN

Present home address (Number and street)                      Apt. no. {2D Barcode of scan line data}

Address line 2 (P.O. Box address for mailing use only)

City, town or post office                               State Zip code

Foreign country name, province/county, postal code                     Amount of estimated tax you are paying by check or money order Round to nearest dollar
                                                                                                                                                             .00

L-1040ES                                                                LANSING                                                       2021  EST 04Q
                                                        ESTIMATED INCOME TAX PAYMENT VOUCHER FOURTH 
                                                              QUARTER - PAYMENT DUE JANUARY 31, 2022

Taxpayer Name:

Social Security No:

Due on or Before:                         1/31/2022, for tax year 2021*

Payment:                                  $

Payment Method:                           Make payment by check or money order payable to "City of Lansing." Write your social security number, 
                                          daytime phone number, and "2021 L-1040ES" on your check or money order. DO NOT SEND CASH. To 
                                          pay by credit card or direct debit, see income tax website of the City of Lansing. Not all  
                                          cities accept credit card or direct debit payments.  

Additional Information:                   The spouse of the joint filing taxpayer may use this payment voucher to make estimated income tax 
                                          payments under his or her own social security number by listing their name and social security number as 
                                          the taxpayer on this payment   voucher.

Address for Payment:                      City of Lansing Income Tax Department
                                          PO Box 40756 
                                          Lansing, MI  48901

* Due Date If the due date falls on a Saturday, Sunday or holiday, the due date is the next business day.

Taxpayer Records:                         Amount Paid: 
                                          Check Number:
                                          Date Mailed: 

                                                                                                                                      Revised: 12/8/20
        KEEP TOP PORTION FOR YOUR RECORDS.  SEND BOTTOM PORTION WITH YOUR PAYMENT 
                                                                       v   DETACH HERE  v
                                                                                                                                      Revised: 12/8/20
                                                                        LANSING
L-1040ES                                   FOURTH QUARTER ESTIMATED INCOME TAX PAYMENT VOUCHER                                        2021 EST 04Q
                                                                      Mail To: Lansing Income Tax Department
NACTP #                                                                 PO Box 40756 
                                                                        Lansing, MI 48901
EFIN #                                                                                                                                Due Date:  01/31/2022
Taxpayer's first name, initial, last name                              Taxpayer's SSN

If joint return spouse's first name, initial, last name                If joint payment, spouse's SSN

Present home address (Number and street)                      Apt. no. {2D Barcode of scan line data}

Address line 2 (P.O. Box address for mailing use only)

City, town or post office                               State Zip code

Foreign country name, province/county, postal code                     Amount of estimated tax you are paying by check or money order Round to nearest dollar
                                                                                                                                                             .00

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