BR-1040                              BIG RAPIDS                                                       2020                                                            20MI-BR-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 Address line 2 (P.O. Box address for mailing use only)                                                                  Single        Married filing jointly
side of the signature area
                                     City, town or post office                                       State   Zip code                                        Married filing separately. Enter spouse's 
Mark box (X) below if;                                                                                                                                       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
          1.   Wages, salaries, tips, etc. ( W-2 forms must be attached)          1                                 .00                                              .00                                .00
SEND 
COPY OF   2.   Taxable interest                                                   2                                 .00                                              .00                                .00
PAGE 1 OF 3.   Ordinary dividends                                                 3                                 .00                                              .00                                .00
FEDERAL   4.   Taxable refunds, credits or offsets of state and local income taxes 4                                .00                                              .00   NOT TAXABLE
RETURN
          5.   Alimony received                                                   5                                 .00                                              .00                                .00
          6.   Business income or (loss) (Attach copy of federal Schedule C)      6                                 .00                                              .00                                .00
          7.   Capital gain or (loss)            
               (Attach copy of fed. Sch. D)      7a.    Mark if federal           7                                 .00                                              .00                                .00
                                                        Sch. D not required
          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
          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 (Att. copy of fed. Sch. K-1) 12                 NOT APPLICABLE                                                  .00                                .00
          13. Farm income or (loss) (Attach copy of federal Schedule F)           13                                .00                                              .00                                .00
SEND  W-2    14. Unemployment compensation                                        14                                .00                                              .00   NOT TAXABLE
FORMS     15. Social security benefits                                            15                                .00                                              .00   NOT TAXABLE
          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 BR-1040, page 2, box 1h, on line 21a and multiply 
                                     this number by the value of an exemption and enter on line 21b)                                               21a               21b                                .00
          22.             Total income subject to tax (Subtract line 21b from line 20)                                                                               22                                 .00
          23.          Tax at                (Multiply line 22 by resident or nonresident tax rate for city and enter tax on line 23b, or if using 
               1% or 1/2%            Schedule TC to compute tax, check box 23a and enter tax from Schedule TC, line 23d)                           23a               23b                                .00
               Payments               Big Rapids tax withheld      Other tax payments (est, extension,         Credit for tax paid                         Total 
          24. and                                                  cr fwd, partnership & tax option corp)           to another city                        payment
               credits    24a                           .00        24b                               .00 24c                                       .00     s    &    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 24d) MAKE CHECK OR MONEY ORDER                                  PAY WITH
CHECK OR  TAX DUE         26. PAYABLE TO: CITY OF BIG RAPIDS
MONEY                                                                                                                                                  RETURN        26                                 .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               Community Pool                      Community Library                                                               Total     
          28. overpayment                                                                                                                                  donation
               donated    28a                           .00        28b                               .00                                                   s         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
                                                 31a    Refund                   31c    Routing 
               Direct deposit refund                    (direct deposit)                number
          31. (Mark (X) appropriate box                                           31d   Account 
               31a and complete lines                                                   number
               31c, 31d and 31e)
                                                                                  31e   Account Type:        31e1. Checking                              31e2.  Savings
          MAIL TO:  CITY OF BIG RAPIDS, INCOME TAX DEPARTMENT, 226 NORTH MICHIGAN AVE, BIG RAPIDS, MI, 49307                                                               Revised 01/26/2021
                                                                           OR
          MAIL TO:  CITY OF BIG RAPIDS, INCOME TAX PROCESSING CENTER, P.O. BOX 536, EATON RAPIDS, MI, 48827-0536

                                                                    Taxpayer's name                                                         Taxpayer's SSN
BR-1040, PAGE 2                                                                                                                                                                                            20MI-BR-1040-2
CF 1040  PAGE 2                                                                                                                                                                                                 c
EXEMPTIONS                                                              Date of birth (mm/dd/yyyy)                                   Regular
                                                         1a. You                                                                                                                                           1e. Enter the number of  
SCHEDULE                                                                                                                                                                                                           boxes checked on  
                                                         1b. Spouse                                                                                                                                                lines 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 
                                                                                                                                                                                                                   dependent children 
1.                                                                                                                                                                                                                 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; 
7.                                                                                                                                                                                                                 enter here and also on 
8.                                                                                                                                                                                                                 page 1, 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               COLUMN F
#                                   T or S     SOCIAL SECURITY NUMBER EMPLOYER'S ID NUMBER                                   EXCLUDED WAGES                   FAILURE TO          BR TAX WITHHELD                              LOCALITY NAME
                                               (Form W-2, box a)       (Form W-2, box b)                      (Attach Excluded Wages Sch)                     ATTACH W-2          (Form W-2, box 19)                       (Form W-2, box 20)
 1.                                                                                                                                         .00            FORMS TO PAGE                                           .00
 2.                                                                                                                                         .00               1 WILL DELAY                                         .00
 3.                                                                                                                                                        PROCESSING OF 
                                                                                                                                            .00            RETURN.  WAGE                                           .00
 4.                                                                                                                                         .00               INFORMATION                                          .00
 5.                                                                                                                                         .00               STATEMENTS                                           .00
 6.                                                                                                                                                           PRINTED FROM 
                                                                                                                                            .00                 TAX                                                .00
 7.                                                                                                                                         .00               PREPARATION                                          .00
 8.                                                                                                                                         .00               SOFTWARE ARE                                         .00
 9.                                                                                                                                                             NOT 
                                                                                                                                            .00               ACCEPTABLE                                           .00
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 & 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  (Attach copy of BR-2106 and detailed list)                                                                                               3                                    .00
 4.                                 Moving expenses  (Into city area only, Military 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 this           FROM                 TO
                                               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 I am a resident claiming a credit for taxes paid to another city, I acknowledge and consent to the City’s verification of unrefunded payment 
                                              to that city.     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 01/26/2021

Taxpayer's name                                                Taxpayer's SSN
                                                                                                                     2020 BIG RAPIDS
WAGES AND EXCLUDIBLE WAGES SCHEDULE - BR-1040, PAGE 1, LINE 1, COLUMN B                                                                                                      Attachment 2-1
All W-2 forms must be attached to page 1 of the return                                                                                                                       Revised 01/26/2021
Use this form to provide details for all Forms W-2 and all other wage income reported on federal Forms 1040 (line 7),1040A (line 7), or 1040EZ (line 1) 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 (Forms 1040, line 7; 1040A; line 7; or 1040EZ, line 1). Excludible wages for each 
employer are also reported on Form BR-1040, page 2, Excluded Wages and Tax Withheld Schedule and the total amount of excludible wages is reported on Form BR-1040, page 1, line 1, col. 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 BIG RAPIDS
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); report statutory 
employee wages as zero 
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 city 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 city 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 city 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 the city
13. Actual number of days or hours worked 
(Line 11 less line 12)
14. Enter actual number of days or hours 
worked in city
15. Percentage of days or hours 
worked in city (Line 14 divided by                                                 %                                    %                                                                              %
line 13; default is 100%)
16. Wages earned in city (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 
BIG RAPIDS
20. Total excludible wages (Line 17 plus line 
18; Enter here and  on  BR-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 BR-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 BR-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 BR-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.