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                                                                                                                                                                                                                     CLEAR FORM
                          CITY OF PONTIAC RESIDENT INDIVIDUAL INCOME TAX RETURN
P-1040R                                                             Due April 30, 2021                                                                                                                                  2020
Your first name & initial                       Last name                                       Birthdate    Your Social Security Number--REQUIRED

If joint, spouse's first name & initial         Last name                                       Birthdate
                                                                                                             Spouse's Social Security Number
Physical home address (Number and street or rural route) include apartment # if any.

City, town or post office                                             State              Zip code            Daytime phone                                                                              Evening phone
                                                                                    Taxpayer only
Part Year Resident from _____/_____/_____ to _____/_____/_____                      Spouse only              If married, is spouse filing                                                                   Yes         No
Former Address:                                                                     Both                     a separate return?
Schedule 1      Exemption Amount
                Regular         65 or over  Blind                     Regular          65 or over   Blind
YOURSELF                                                     SPOUSE                                          1. Number of boxes checked to the left                                                                  1.
DEPENDENTS
Name (first, middle initial, and last name)                         Social Security Number          Relationship                                                                           How many months
If more than four dependents, attach an additional schedule.                                                                                                                               living in your home

                                                                                                                                                                                                                     2.
                                2.      Number of dependent children and/or other dependents which you listed on your federal return
                                                                                                                                                                                                                     3.
                                3.      Total number of exemptions--add lines 1 and 2 and enter on line 5 of RETURN SUMMARY below
Schedule 2      Wage Detail                     ATTACH PONTIAC COPY OF FORM(S) W-2                               Column A                                                                                   Column B
Enter gross wages, salaries, commission, tips, sick pay, etc earned everywhere.                              Pontiac tax                                                                                    Total wages from
Employer's name                             Street address of actual work location(s)                            withheld                                                                                   Box 1 of W-2
                                                                                                                                                                                           .00                                     .00
                                                                                                                                                                                           .00                                     .00
                                                                                                                                                                                           .00                                     .00
                                                                                                                                                                                           .00                                     .00
Do not include S.U.B. pay                                                                         Totals 1a.                                                                               .00          1b.                        .00
Schedule 3      Payments
1. Tax withheld by your employer from line 1a. of Schedule 2 above                                  1.                                                                                     .00
2. 2020 estimated payments, credit from 2019 P-1040R, payment with extension                        2.                                                                                     .00
3. Credit for tax paid to another city--from Page 2, Worksheet 1                                    3.                                                                                     .00          Attach copy of other return
4. Credit for taxes paid by partnership on behalf of partner (Provide name and Tax ID)              4..                                                                                    .00
5. Total payments--enter here and on line 8 of RETURN SUMMARY below                                 5.                                                                                     .00
                1. Total wages, salaries and tips from Schedule 2, line 1b.                               Attach your W-2 form(s)                                                                       1.                         .00
RETURN          2. Other income/loss from Page 2, Schedule 4, line 11                                                                                                                                   2.                         .00
SUMMARY         3. Deductions from Page 2, Schedule 5, Line 5  (Enter as negative amount)                                                                                                               3.                         .00
                4. Combine lines 1, 2 and 3.  This is your total Pontiac income                                                                                                                         4.                         .00
Exemptions      5. Enter number of exemptions from Schedule 1, line 3 here ___ then multply by $600.00 and enter in box 5                                                                               5.                         .00
Taxable Income  6. Subtract line 5 from line 4.  This is your taxable income                                                                                                                            6.                         .00
  PONTIAC TAX   7. Multiply line 6 by one percent (.01)  This is your Pontiac tax                                                                                                          Tax >>>
                If you prepared Schedule L for Part-Year resident, enter the tax amount and check the box.                                                                                              7.                         .00
Payments        8. Total of Pontiac payments from Schedule 3, line 5                                                                                                                       Payments >>> 8.                         .00
   Tax          9. If tax (line 7) is larger than payments (line 8) enter amount you owe. MAKE CHECK
                PAYABLE TO CITY OF PONTIAC OR PAY WITH A DIRECT ELECTRONIC WITHDRAWAL                                                                                                      Pay With    
   Due          (Mark pay tax due-direct withdraw, line 14b, and complete lines 14 c, d, & e)                                                                                               Return >>>  9.                         .00
Overpayment     10. If payments (line 8) are larger than tax (line 7) ENTER OVERPAYMENT                      Overpayment >>>                                                                            10.                        .00
Credit to 2021  11. Amount of overpayment to be held and applied to your 2021 estimated tax                  Credit to 2021 >>>                                                                         11.                        .00
Donation        12. Overpayment donated to City of Pontiac                                                                                                                                 Donation >>> 12.                        .00
Refund          13. Amount of overpayment to be refunded (For direct deposit, mark refund box,
                line 14a, and complete lines 14 c, d, & e)                                                                                                                                 Refund >>>   13.                        .00
Direct Deposit  14. Direct deposit refund or direct withdrawal payment   Mark one:       14a        Refund-direct deposit                                                                  14b          Pay tax due-direct withdraw
   or           c. Routing number                                                                   e. Type of account:                                                                    Checking         Savings
Direct Payment  d. Account number
  I have read this return.  Under the penalties of perjury, I declare that to the best of my knowledge and belief the return is true, correct and accurately lists all amounts and sources 
  of Pontiac income I received during the tax year.  If prepared by a person other than the taxpayer, his/her declaration is based on all information of which he/she has any knowledge.
                Your signature                               Spouse's signature if joint return              Paid preparer's signature
PLEASE
SIGN HERE       Date            Your occupation              Date               Spouse's occupation          Address
                                        YOU MUST ATTACH A COPY OF PAGES 1 AND 2 OF YOUR 2020 FEDERAL 1040
                             If payment is included mail return to: City of Pontiac 1040 Payments; PO Box 530; Eaton Rapids, MI 48827-0530
                          If no payment is included mail return to: Income Tax Division; City of Pontiac; PO Box 530; Eaton Rapids, MI 48827-0530



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                                CITY OF PONTIAC RESIDENT INDIVIDUAL INCOME TAX RETURN
Page 2                                                                   P-1040R                                                                            2020
Schedule 4             Other Income/Loss
PART YEAR RESIDENTS INCLUDE ONLY INCOME/LOSS ATTRIBUTABLE TO PERIOD OF RESIDENCY
                                                                                      Less interest on 
                                                                                      obligations from the 
                                                                                      United States or 
                                                                                      subordinate units.
1. Interest income from Federal return                    1a.                .00                              1b.          .00     1c.                      .00
2. Dividend income from Federal return                    2a.                .00            U.S. dividends    2b.          .00     2c.                      .00
3. Net income/loss from business or profession--attach 
    Federal Schedule C                                    3a.                .00        SEP deduction         3b.          .00     3c.                      .00
4. Net income/loss from rents/royalties--Federal Schedule E, page 1  (All federal schedules must be attached.)                     4.                       .00
5. Income/loss from partnerships--attach Federal Schedule E, page 2                                                                5.                       .00
6. Income/loss from the sale or exchange of property per your federal forms. (Capital gains)--Federal Schedule D/Form 8949         6.                       .00
7. Distributions from Subchapter S corporations--attach Federal Schedule K-1                                                       7.                       .00
8. Income from estates/trusts--Federal Schedule E, page 2                                                                          8.                       .00
9. Distributions from profit sharing plans, or premature distributions from pension plans and/or IRAs.                             9.                       .00
10. Other income (alimony received (see instructions), gambling winnings from lotteries, casinos, bingo halls, racetracks, taxable 
    scholarships, etc.) Include copy of Part I of Schedule 1 from Federal 1040, and any supporting schedules.                      10.                      .00
11. Total--combine lines 1c. through 10--enter here and on page 1, line 2 of return summary                                        11.                      .00

Schedule 5             Deductions
PART YEAR RESIDENTS ALLOCATE DEDUCTIONS FOR PERIOD OF RESIDENCY
1. IRA deduction--attach Schedule 1 of Federal 1040       (No deduction is allowed for contributions to a ROTH IRA)                1.                       .00
2. Employee business expenses--see instructions and attach detailed list                                                           2.                       .00
3. Moving expenses--see instructions and attach Federal 3903                                                                       3.                       .00
4. Alimony paid--see instructions and attach Schedule 1 of Federal 1040.                                                           4.                       .00
5. Total--add lines 1 through 4--enter here and on page 1, line 3 of RETURN SUMMARY                                                5.                       .00

Worksheet 1            Credit for Tax Paid to Another City

1. Total income earned in other city after deductions (before exemptions) from 2019 non-resident city return                       1.                       .00
2. Less:  exemption amount from Pontiac RETURN SUMMARY--page 1, line 5                                                             2.                       .00
3. Comparative income subject to tax by other city. (Line 1 less Line 2)                                                           3.                       .00
4. Credit tax rate 1/2% (0.005)                                                                                                    4.                       .005
5. Multiply line 4 by line 3--enter here and on page 1, Schedule 3 (Payments), line 3                                              5.                       .00
    (Credit is limited to actual tax liability from other city's return)
Part year residents:   Include income on line 1 of this worksheet only to the extent that it is taxable by Pontiac as a resident
                       and taxable by another city that imposes an income tax as a non-resident
Note: You must complete a separate Worksheet 1 for each city in which you filed a non-resident return
                                       YOU MUST ATTACH A COPY OF PAGE ONE OF THE OTHER CITY'S RETURN
                                                         Summary of Required Attachments
    All Filers:                                                                             If Applicable:
    All form W-2's                                                                                 Federal Schedule 1
    Page 1 and 2 of Federal Form 1040                                                              Federal Form 3903
                                                                                                     Federal Schedule C
    Filers Taking a Credit for Tax Paid to Another City:                                             Federal Schedule D, Forms 8949, 4797, 6252
    Copy of page one of the other city(ies) return                                                 Federal Schedule E including Federal Schedule K-1 
                                                                                                       for all S corporations shown on Schedule E, if any
                                                                                                     Copies of all forms 1099-R for taxpayers under age 65

                                                                         IMPORTANT
    Detailed supporting schedules MUST be submitted with this return. Failure to attach schedules or attaching incomplete schedules can result in deductions and 
    losses being disallowed or delay the processing of your return until acceptable schedules are obtained.

                       If you have any questions regarding the City of Pontiac Income Tax, please call (248) 758-3236
                                                              Third Party Designee
Do you want to allow another person to discuss this return with the Income Tax Department?                     Yes--Complete the following:              No

Designee's Name:                                                                            Phone No.          (         ) 






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