INDIVIDUAL – 2019
Tax Office Use Only: Tax Office Use Only: Tax Office Use Only
INCOME TAX RETURN
DATE RECEIVED Taxpayer's Social
Security No.
FEDERAL 1040 FAIRFIELD Home Telephone No. Business Telephone No.
SIGNATURE ON FORM Due Date 04/15/2020
REFUND
Spouse's Social
ESTIMATED TAXES DUE A COPY OF THE FEDERAL Security No.
BALANCE DUE 1040 AND SIGNATURE(S) Spouse's
ARE REQUIRED Name
PAYMENT RECEIVED
Home Telephone No. Business Telephone No.
TAXPAYER NAME AND CURRENT ADDRESS: Filing Status IF YOU HAVE MOVED DURING
Single RESIDENT TAX YEAR - GIVE DATES
INTO
Married filing joint NON- / /
Married filing separate RESIDENT OUT OF / /
IF YOU RENT, PLEASE GIVE LANDLORD'S INFORMATION
NAME
ADDRESS
IF TAXPAYER AND SPOUSE ARE FULLY RETIRED AND/OR WITHOUT TAXABLE INCOME, PLACE AN “X” IN THE BOX, ATTACH FORM 1040 AND
COMPLETE THE SIGNATURE SECTION BELOW.
Income
1. Wages, salaries, tips, etc. (attach W2(s)) 1. ____________________
2. Other taxable income (attach schedule C, E, F, K-1, 1099-Misc.) 2. ____________________
3. Total taxable income (add lines 1 and 2) 3. _____________
Payments and Credits
4. Fairfield tax due before credits (1.5% of line 3) 4. ____________________
5. Estimated tax payments made to Fairfield 5. ____________________
6. Taxes withheld and paid to Fairfield 6. ____________________
7. Overpayments from prior years 7. ____________________
8. Taxes withheld and paid to other localities
(credit cannot exceed 1.5% of Fairfield taxable income) 8. ____________________
9. Total credits (add lines 5 through 8) 9. _____________
Refund (issued if greater than $10.00)
10. If line 9 is greater than line 4, subtract line 4 from line 9. This is the amount you overpaid. 10. _____________
11. Amount of line 10 to be credited to next year’s estimate 11. ___________________
12. Amount of line 10 to be refunded 12. ___________________
Staple check here
Tax Due (if greater than $10.00)
13. If line 4 is more than line 9, subtract line 9 from line 4, this is the amount you owe. 13. _____________
14. Penalties and interest Late file Late Pay Late Estimate Interest 14. _____________
Declaration of Estimates for 2020 (required if tax liability after withholding credit for 2019 is $200.00 or more)
15. Estimated income 15. __________________
16. Estimated tax due. Multiply line 15 by 1.50% 16. __________________
17. Taxes to be withheld and paid to Fairfield and other localities 17. __________________
18. Prior credit applied to estimated tax payments (from line 11) 18. __________________
19. Net estimated tax due (subtract line 17 and line 18 from line 16) 19. __________________
20. Minimum amount due for first quarter (multiply line 19 by 22.5%) 20. __________________
Amount Due
21. Total amount due (add lines 13, 14, and 20) 21. _____________
The undersigned declares that this return (and accompanying schedules) is true, correct and complete for the taxable period stated and that the figures used herein are the same as used for Federal income tax purposes.
May we discuss this return with your tax practitioner? yes ___ no Credit Card
Authorization
Signature of Taxpayer Date Card Type: MasterCard Visa Discover
Amount Paid (line 21): Phone Number
Signature of Taxpayer Spouse Date
Cardholder Name (as shown on card)
Signature of Preparer If other than Taxpayer Card Number:
3 Digit Code (Back of Card): Expiration Date (MM/YY)
Phone Number of Tax Preparer