INDIVIDUAL RETURN
SAGINAW                                                                        DUE April 30, 2021                                                                                       2020 S-1040 
Your First Name and Initial                   Last Name                                          Social Security Number                                 FILING STATUS               MARRIED FILING SEPARATELY 
                                                                                                                                                            SINGLE                   Enter Spouse's SSN # and Full Name 
If Joint, Spouse's First Name and Initial     Last Name                                        Spouse's Social Security Number                            MARRIED FILING JOINT      NAME: 
                                                                                                                                                          MARRIED FILING SEPARATELY SSN# 
Mailing Address                                                                                City/Town                                                ~ State             Zip Code                                                                           TOTAL EXEMPTIONS 
                                                                                                                                                          I                 I 
           RESIDENCY STATUS - MUST COMPLETE ADDRESS & EMPLOYER SECTION ON PAGE 2 

                RESIDENT                           ENTERTHE CITYALLOFINCOMESAGINAW.INCLUDING WAGES, TIPS, BONUSES, SICK PAY, RETIREMENT BUYOUTS, ETC, EARNED IN AND OUTSIDE 
         LJ 
                PART-YEAR RESIDENT INCLUDENON-RESIDENT.ALL INCOME AND WAGES EARNED DURING RESIDENCY AND WAGES EARNED IN THE CITY OF SAGINAW WHILE A 

         □ NONRESIDENT                             IF YOU WORKED FOR AN EMPLOYER IN THE CITY OUTSIDE THE CITY OF SAGINAW FOR AN EMPLOYER, GO TO PAGE 2 AND USE THE NONRESIDENT WAGE ALLOCATION.  OF SAGINAW ONLY, PUT TOTAL WAGES IN COLUMN SUBJECT TO TAX.   IF YOU WORKED IN AND 
         n 
           INCOME                                                                                                                                       From Federal Return Not Subject to Tax                                                                Subject to Tax
         1      Wages, salaries, tips, bonuses, sick pay, retirement buyouts, etc.                                                                   1                                                                                                                      00 
ATTACH   2.     Taxable Interest and Ordinary Dividends.                 (RESIDENTS  & PART-YEAR RESIDENTS ONLY)                                     2                                                                                                                      00 
COPY OF  3.     Alimony received.                                                                                                                    3                                                                                                                      00 
PAGE 1 & 4.     Business income.  (Attach copy of federal Schedule C)                                                                                4                                                                                                                      00 
SCHEDULE 5.     Capital gains or losses.  (Attach copy of federal Schedule D)                                                                        5                                                                                                                      00 
 1 OF    6.     Other gains or losses.  (Attach copy of federal Form 4797)                                                                           6                                                                                                                      00 
FEDERAL  7.     Taxable IRA distributions. (Attach copy of Form 1099-R)                                                                              7                                                                                                                      00 
RETURN   8.     Taxable pension distributions. (Attach copy of Form 1099-R)                                                                          8                                                                                                                      00 
         9.     Rental real estate, royalties, partnerships, trusts, etc.   (Attach copy of federal Sch. E)                                          9                                                                                                                      00 
         10.    Subchapter S Corp distributions/dividends  (Attach copy of federal Schedule K-1)  Residents Only.                                    10  NOT APPLICABLE                                                                                                     00 
         11.    Farm income or (loss).   (Attach copy of federal Schedule F)                                                                         11                                                                                                                     00 
ATTACH   12.    Military pay and Unemployment                 NOT TAXABLE TO CITY                                                                    12                        NOT TAXABLE        NOT TAXABLE                                                               00 
W-2's    13.    Social security benefits.                                NOT TAXABLE TO CITY                                                         13                        NOT TAXABLE        NOT TAXABLE                                                               00 
AND      14.    Other income.  List type and amount.                      Type                                                              Amount $ 14                                                                                                                     00 
FORMS    15.                 Total income.  Add lines 1 through 14.                                                                                  15                                                                                                                     00 
HERE        DEDUCTIONS                        See instructions.  Deductions must be allocated on the same basis as related income. 
         16.    Individual Retirement Account deduction.  (Attach copy of SCHEDULE 1 of federal return)                                                                 16                 00 
         17.    Self Employed SEP, SIMPLE and qualified plans.  (Attach copy of SCHEDULE 1 of federal return)                                                           17                 00 
         18.    Employee business expenses.   (See Instructions and attach copy of federal Form 2106)                                                                   18                 00 
         19.    Moving expenses.  (Into taxing area only)  (attach copy of federal Form 3903)                                                                           19                 00 
         20     Alimony paid.  DO NOT INCLUDE CHILD SUPPORT   (Attach copy of SCHEDULE 1 of federal return)                                                             20                 00 
         21     Renaissance Zone deduction.   (ATTACH ORIGINAL CERTIFICATE)                                                                                             21                 00 
         22      Total deductions.  Add lines 16 through 21                                                                                                                                22                                                                               00 
         23     Total income after deductions. Subtract line 22 from line 15.                                                                                                              23                                                                               00 
         24     Amount for exemptions.  (Number of exemptions,  _____ x $750)                    MUST COMPLETE EXEMPTION SCHEDULE ON PAGE 2                                                24                                                                               00 
ATTACH   25     Total income subject to tax.  Subtract line 24 from line 23                                                                                                                25                                                                               00 
CHECK    26     Tax at       MULTIPLY LINE 25 BY                               .015 (Resident)   .0075 (Non-Resident)                                   % (Partial Resident-from table)    26                                                                               00 
OR          PAYMENTS AND CREDITS                                  (If line 26 exceeds $100 see instructions for making estimated tax payments) 
MONEY    27     Tax withheld by your employer (ATTACH 2020 W-2 FORMS showing Saginaw Tax Withheld)                                                                      27                 00 
ORDER    28     Payments on 2020 Declaration of Estimated Income Tax payments with an extension and credits forward from 2019                                           28                 00 
HERE     29     Tax paid to another city and for tax paid by a partnership. (ATTACH  COPY OF OTHER CITY'S RETURN)                                                       29                 00 
         30                  Total payments and credits.  Add lines 27 through 29                                                                                                          30                                                                               00 
         31. If tax (line 26) is larger than payments(line 30) you OWE TAX.  Please enter amount due and submit payment with                                                               31 
         return.  Or enter bank information for ELECTRONIC BANK WITHDRAWAL 
                                                                                                                                                            I TAX DUE                                                                                                       00 
         32.If payment(line 30) is larger than tax (line 26) ENTER OVERPAYMENT                                                                                              REFUND 
         33.Overpayment to be HELD and APPLIED TO 2021 estimated tax.                                                                                                       CREDIT FORWARD                                                                  (               ) 
         34.DONATIONS for annual fireworks, please donate $1.00 or more                                                                                                     DONATION                                                                        (               ) 

         35.REFUND subtract line 33 & 34 from line 32, this is your total refund                                                                                            REFUND                                                                                          00 
         ELECTRONIC                       36  Mark one:    LJ            Refund - Direct Deposit I   J   Pay Tax Due - Electronic funds withdrawal 
         REFUND OR 
                                              a. Routing number          I  I  I  I  I           I  I  I  I 
         PAYMENT 
         INFORMATION                          b. Account number          I I I I I               I I I I I I  I  I I                                        C. Account Type:            n  Checking                                                           n savings 

         MAIL ALL RETURNS (PAYMENTS/TAX DUE, REFUNDS & NO REFUND/NO TAX DUE) TO:                                                                          INCOME TAX OFFICE 
                                                                                                                                                          1315 S  WASHINGTON 
                                                                                                                                                          SAGINAW, MI 48601 
                                                                                                   Page 1 

                             FAILURE TO FILL OUT EMPLOYMENT INFORMATION/EXEMPTION SCHEDULE AND ADDRESSES 
                     OR FAILURE TO ATTACH DOCUMENTATION OR ATTACHING INCORRECT OR INCOMPLETE DOCUMENTATION 
                     WILL DELAY PROCESSING OF RETURN AND MAY RESULT IN  DEDUCTIONS AND LOSSES BEING DISALLOWED 
     REQUIRED--MUST BE FILLED OUT COMPLETELY       (NOT COMPLETING WILL DELAY PROCESSING YOUR RETURN ) 
EMPLOYERS -  LIST ALL EMPLOYERS DURING 2020 & ACTUAL JOB LOCATION ( if more than 4 list on separate sheet & attach 
                                                                                                FROM                       TO 
                                   ADDRESS OF                                                                                                     Total  Wages 
                                                  ACTUAL WORK                                                                                     from Box 1 on 
                                   LOCATION (may be different from                                                                                 W2 from       Saginaw Tax 
 EMPLOYERS                                  address on W-2)                                  Month      Day        Month                 Day       employer           Withheld 

                                                                                                                                                                                      Enter+-- total on page 
                                                                                     Enter total on page one, in box 1                                                                one,  line 27 
EXEMPTIONS SCHEDULE 
                     Date of birth          Regular             65 & over              Blind                    Box A.  Number of boxes checked                                       Box A 
You 
Spouse                                        B                 B                    B 
                                                                                                                Box B.   Number of dependents                                         Box B 
DEPENDENTS                                                                                                      (attach copy of Page 1 of Federal Return)
                                                                                                                Box C.  Total Exemptions                                              Box C 
                     Attach Copy of Federal Return Page 1                                                          (Add Box A and Box B)                                _____. 
                                                                                                                                                   
                                                                                                                                         Enter  Box C amount on page 1 
ADDRESSES                                   Enter name and address used on 2019 return.   (If same as         2020 write "SAME".   If none filed, please give reason. ) 
                                            I 
LIST ALL ADDRESSES WHERE YOU RESIDED IN 2020 (if more than 2  list on separate sheet and attach) 
INDICATE:                   T = TAXPAYER              S = SPOUSE                              B =  Both                                         FROM                               TO 
   T,S, B                                    ADDRESS                                                                               MONTH       DAY                  MONTH                   DAY 

SCHEDULE A - NONRESIDENT WAGE ALLOCATION  (If you were a resident at any time during the year, do not use this Schedule) 
If you worked by remote from your home outside the City of Saginaw for hours approximating your regular shift during COVID, use schedule below 
and attach a letter of verification from your employer. 
EMPLOYER NAME:   (A COMPUTATION MUST BE MADE FOR EACH EMPLOYER)                                                                 Example 
A. Actual number of days worked everywhere for employer during 2020 (do not include vacation, 
 weekends off, holiday and sick days)                                                                                                      100 
B. Actual number of days worked outside the City of Saginaw                                                                                   20 
C. Subtract line  Bfrom line       A                                                                                                          80 
D. Percentage of days worked in the City of Saginaw (Line  Cdivided by Line                   A)                                           80%                 %               %                         % 
E. Total wages shown on W-2,  box 1                                                                                                   $20,000 
F. Wages earned in the Saginaw City.  Line  Emultiplied by percentage on line                   D                                     $16,000 
                     Enter amount from line F on page 1, line 1, in column Subject to Tax 
SCHEDULE B - EXCLUDIBLE INTEREST AND DIVIDEND INCOME (FOR USE BY RESIDENTS ONLY) 
Excludible Interest Income                                                                                    Excludible Dividend Income 
Interest income from federal return                                                                           Dividend income from federal return 
Excludible interest income                                                                                    Excludible dividend income
      Interest from federal obligations                                                                            Dividend from federal obligations
      Interest from Subchapter S corp                                                                              Other excludible dividend income 
     Other excludible interest income 
     Total excludible interest income                                                                              Total excludible dividend income
     Taxable interest income                                                                                       Taxable dividend income 
SCHEDULE C - BUSINESS INCOME, BUSINESS ALLOCATION FORMULA AND PROFIT OR LOSS (ATTACH FEDERAL SCHEDULE C). 
SCHEDULE D - SALE OR EXCHANGE OF PROPERTY (ATTACH FEDERAL FORM SCHEDULE D) 
SCHEDULE E - SUPPLEMENTAL INCOME (ATTACH FEDERAL FORM SCHEDULE E) 
1.  Rents (Excludable by NON-RESIDENTS only on property located outside the City of Saginaw) 
2.  Partnerships (Excludable by NON-RESIDENTS only on partnerships located outside the City of Saginaw) 
3.  Other (Identify) 
4.  Total Excludable Supplemental Income (Add Lines 1, 2 and 3) 
THIRD-PARTY DESIGNEE 
Do you want to allow another person to discuss this return with the Income Tax Department?                               I               Yes. Complete the following    I  I          No 
Designee's                                                                                              Phone 
name                                                                                                    No. ( ) 
I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct 
and complete.  If prepared by a person other than taxpayer, the preparer's declaration is based on all information of which preparer has any knowledge. 
 _____.                                                                                                            /     /                                                                   /       / 
SIGN                 TAXPAYERS' SIGNATURE-      If joint        return, both husband and wife must      sign.      DATE         PRINT NAME OF PREPARER                                      DATE
 ------.                                                                                                            /    /      (             ) 
                     SPOUSE'S SIGNATURE                                                                            DATE         PREPARER'S PHONE NUMBER
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