CITY OF PORT HURON - INDIVIDUAL INCOME TAX RETURN PH-1040 This return is due May 1, 2023 2022 Your first name and initial Last name Your social security number Residency Status SEE INSTRUCTIONS If a joint return, spouses first name and initial Last name Spouse's social security number RESIDENT NONRESIDENT Home address (number and street) if a P.O. Box or if this is not your actual residence, see instructions Did you file a 202 1Port Huron return? PARTIAL RESIDENT Yes No City, town or post office, state and ZIP code Partial residents must complete If yes, is the name(s), filing status and Schedule L - see instructions address the same as last year? If you were a resident for only part of the year, indicate when you were a resident: Yes No If no, explain and give date of change From: to: former address: PRESENT EMPLOYER(S) ' Regular 65 or Older Blind Deaf Disabled EXEMPTIONS Additional Number of boxes checked (see instructions) You: exemptions Note: claim an exemption even if you if you or your are a dependent on another return Dependents Spouse: spouse are: First name Last name Social security number Relationship to you Number of dependents you claim on your federal return (list to the left) Total number of exemptions (add the numbers entered in the boxes above) Column I Column II Column III Amounts from your Column I minus Column II Federal Return Exclusions Income subject to tax 1. Wages, salaries, tips, etc. 00 00 00 2. Interest income RESIDENTS ONLY (partial residents see Schedule L) 00 00 00 3. Dividend income A RESIDENTS ONLY (partial residents see Schedule L) 00 00 00 4. Business income or (loss) Attach Federal Schedule C 00 00 00 T 5. Capital gain or (loss) 00 00 00 T 6. Supplemental income or (loss) Attach Federal Schedule E 00 00 00 A 7. Other income 00 00 00 C 8. Adjustments Attach explanation and support 00 00 00 H 9. Total income - add lines 1 through 8 00 10. Exemption Credit. Number of exemptions x $600.00 (from exemptions above) 00 W - 11. TAXABLE INCOME. Subtract line 10 from line 9. If line 10 is greater than line 9, enter -0- 00 2 's 12. TAX multiply line 11 by 1% (.01) if a resident or by ½ of 1% (.005) if a nonresident. Partial residents see Schedule L 00 13. Port Huron tax withheld. You MUST attach W-2's showing the full amount of tax withheld . . 13 00 E 2 14 14. 202 estimated tax payments, extension payments and carried forward from last year . . . . . . H 00 15. Credit for tax paid by a partnership . . . . . . . . . . . . . . . . . . . . . . . . . . 15 R 00 16. Credit for tax paid to another city. Residents only, SEE INSTRUCTIONS . . . . . . . 16 E 00 17. Total payments and credits. Add lines 13, 14, 15 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 00 18. If line 12 is more than line 17, subtract line 17 from line 12. This is your tax due ................................................. BALANCE DUE 18 00 19. If line 17 is more than line 12, subtract line 12 from line 17. This is the amount you overpaid ...................................... Overpayment 19 00 20a 20. Amount of line 19 to be: applied to your 202 3estimated taxes ' 00 or REFUNDED'20b 00 I declare, under penalty of perjury, that the information in this return and attachments is true and I declare under penalty of perjury, that this return is based on all complete to the best of my knowledge. information of which I have knowledge. Your signature Date Preparer's name, address and ID number X Spouse's signature - if a joint return BOTH MUST SIGN Date X Make checks payable to: City of Port Huron Mail to: Income Tax Division Preparer's signature Date 100 McMorran Blvd. IfTopayingpay online,in person,go topaywww.porthuron.org.at the City Treasurer's Office. Port Huron, MI 48060 X |
SCHEDULE A - EXCLUDABLE WAGES 1. Wages earned partly outside of Port Huron - NONRESIDENTS ONLY A. Total number of days you worked for this employer during the year (EXCLUDE vacation and sick days) days B. Actual number of days during the year you worked for this employer inside of the city days C. Number of days you worked outside the city FOR THIS employer during the year - List location below days D. Percentage of days you worked outside the city for this employer (divide line C by line A) % E. Wages you earned from this job during the year (from your W-2) - List location outside the city below $ F. Excludable wages from this job (multiply line E by line D) $ 2. Wages earned by a NONRESIDENT entirely outside the city, but included on the return (line 1, column I) - List location below $ 3. Military pay - Excludable by both residents and nonresidents $ 4. TOTAL EXCLUDABLE WAGES (add line 1F, 2, 3) - Enter the total here and on the front of the return (line 1, column II) $ List the specific location you worked outside of the city ' SCHEDULE B - BUSINESS INCOME EXCLUSIONS 1. Taxable income for the year $ 2. Additions (Note: add back Port Huron income tax deducted from income) - List: $ 3. Subtractions - List: $ 4. Allocable income - line 1 plus line 2, minus line 3 $ 5. Allocation percentage (from schedule below) - If all business was conducted in the city enter 100%, RESIDENTS ENTER 100% % 6. Taxable income - multiply line 4 by line 5, enter the result here $ 7. Excludable income - line 4 minus line 6 $ I II III BUSINESS ALLOCATION FORMULA - NONRESIDENTS ONLY Located everywhere Located in the city Percentage in the city Aa. Average net book value of real and tangible personal property II )I Ab. Gross rentals of real property multiplied by 8 Ac. Total - line Aa plus line Ab % B. Total wages salaries, commissions and other compensation paid to all employees % C. Gross receipts from sales made or services rendered % D. Total of all percentages - add the percentages computed on lines Ac, B and C % E. Average percentage - divide line D by three* - Enter here and on line 5 above % * Note: in determining the average percentage, if a factor does not exist, you must divide line D by the number of factors used Note: If you are authorized to use a special formula, give the date of the administrator's approval letter and attach a schedule detailing the calculation SCHEDULE C - OTHER EXCLUSIONS (Exclude in column II if shown on the front of the return) 1. Interest income from federal, state, or municipal obligations $ 4. Taxable social security benefits $ 2. Unemployment compensation $ 5. State and local refunds included in taxable income $ 3. Pensions and annuities $ 6. Other - describe $ RESIDENTS: The city compares the total income reported on your city return to the income reported on your state return. Provide information in this section that explains any difference between the first line of your state return (adjusted gross income) and the total income reported on this return. SCHEDULE D - ADJUSTMENTS (Explain adjustments claimed) 1. Moving expenses (only Armed Forces on active duty, moving into the taxing area) - Attach Federal Form 3903 $ 2. Employee business expenses SEE INSTRUCTIONS - Attach schedule detailing the amounts $ 3. Alimony paid (allowed for divorce decrees signed PRIOR to January 1, 2019) $ 4. Deductible I.R.A. contributions - YOU MUST ATTACH A RECEIPT for any contribution claimed $ 5. Other - attach documentation and describe: $ 6. Other - attach documentation and describe: $ Note: Nonresidents must prorate income based on the amount of income subject to tax - see instructions List employers who paid you wages and DID NOT WITHHOLD CITY TAX (list only if you did not attach a copy of your W-2 from the employer) Employer's name Work location Wages $ $ $ $ |