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                         2022 

       CITY OF GRAND RAPIDS INCOME TAX 

       NON-RESIDENT FORMS AND INSTRUCTIONS 
             Form GR-1040NR—Individual Return 

For use by individuals who were not residents of the 
       City of Grand Rapids at any time during 2022, but 
       who earned taxable income in Grand Rapids during 
             2022 and by TRUSTS and ESTATES 

FILING DATE: Your return must be filed byMay 1ST, 202 3

REMITTANCE:  Make remittance payable to:  GR City Income Tax 

MAILING ADDRESS:  Mail your return and remittance, with W-2 
             forms to: 

             Grand Rapids Income Tax 
             P.O. Box 347 
             Grand Rapids, MI  49501-0347 

             Telephone number: (616) 456-3415 Option 0 

             Office hours: Monday,Tuesday, Thursday, Friday 
             8 a.m. to 5:00 p.m. Wednesday - 8am to 7pm 
             (April 5th to April 26th) Saturday 8am- 2pm on 
             February 11th, March 11th, March 25th, April 1st, 
             April 15th, April 22nd, & April 29th. 

             Phone hours: 
             Monday through Friday 8 a.m. to 5:00 p.m.  
             Wednesday 8am- 7pm  (March 8th to April 26th)

             Website:  www.grcity.us/incometax

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NONRESIDENTS Wages earned while working from home. The same verification from the
If you lived outside of the Grand Rapids city limits for the entire year but employer will be requested if you exclude wages earned while working at
had income earned inside of the Grand Rapids city limits, you will file a home when Grand Rapids tax was withheld. If you are permanently
non-resident tax return. If you moved during the year and lived both inside working remotely and will not be returning to a Grand Rapids work location,
and outside of the Grand Rapids city limits, you will file as a part-year withholding for Grand Rapids should be ceased. Starting with tax year
resident. See separate part-year tax form, instructions and Sch TC (part- 2022, the CF-COV Covid work allocation worksheet will not be accepted as
year resident schedule) if applicable. mandatory government stay home orders were no longer in place. The
Grand Rapids Income Tax Ordinance (Sec. 141.613,Reg. 13.2) states the
For non-residents, only income earned in the city limits is taxable. Alimony following: the mere fact that a nonresident employee takes work home with
received and gambling winnings are not taxable to non-residents. them and performs such work at their home does not permit for the
allocation of compensation. If an office or other work space is maintained
for you in the city limits and you choose to work from home, this
NONRESIDENT INCOME SUBJECT TO TAX: compensation cannot be allocated/excluded.
1. Compensation for work done or services performed in the Grand Rapids
city limits which includes, but is not limited to, the following: bonuses, Wages are only to be taken from Box 1 of the W-2 form. Wages are not to
commissions, fees, tips, incentive payments, severance pay, vacation pay be taken from Box 18. If you are allocating wages and Box 18 is the
and sick pay. correct taxable amount, you are still required to fill out WAGES AND
2. Net profits from the operation of an unincorporated business, profession EXCLUDIBLE WAGES SCHEDULE.
or other activity attributable to business activity conducted in Grand
Rapids, whether or not such business is located in Grand Rapids. This Line 2 – Taxable interest. In general, interest income is not taxable to
includes business interest income from business activity in Grand non-residents unless related to business income. For example, if you own
Rapids. commercial property in the Grand Rapids city limits and receive income
3. Gains or losses from the sale or exchange of real or tangible personal (such as interest paid on land contract) the interest is taxable.
property located in the Grand Rapids city limits.
4. Net profits from the rental of real or tangible personal property located in Lines 3 and 5 – Dividends and Alimony. Neither item is taxable to non-
Grand Rapids. residents.
5. Premature distributions from an Individual Retirement Account (IRA)
where a deduction was claimed on a current or previous year’s Grand Rapids Line 6 – Business income (or loss) – PLEASE ATTACH FEDERAL SCH
income tax return. C. Any business income earned in the Grand Rapids city limits is taxable
6. Premature distributions from a pension plan attributable to work to non-residents. If you are claiming a loss, please be sure the actual
performed in Grand Rapids. address of the business is provided so we may verify it was in the Grand
7. Deferred compensation earned in Grand Rapids. Rapids city limits or the loss may be disallowed.

Line 7 – Capital Gains (or Losses). Capital gains or losses of a
Wages received while on vacation, holiday and sick pay are taxable at nonresident are included in taxable income to the extent the gains or
the same percentage as your taxable wages, as is third party sick pay. losses are from property located in Grand Rapids. Capital losses from
Severance pay is also taxable at the same percentage as your wages property located in Grand Rapids are allowed to the same extent they are
had been taxable. If you allocated wages prior to receiving severance allowed under the Internal Revenue Code. Unused capital losses may be
pay, a 3 to 5 year average should be used. This income cannot be carried over to future tax years. The capital loss carryover for Grand
excluded merely because it was paid to you after you stopped Rapids may be different than the carryover for federal income tax
physically working in the Grand Rapids city limits. purposes. Deferred capital gain income from installment sales and like-kind
exchange of property located in Grand Rapids are taxable in the year
Wage Allocations on Commissions, etc. A nonresident salesperson paid recognized on the taxpayer’s federal income tax return. Flow through
on a commission basis or other results achieved should allocate wages income or loss from an S corporation reported on a nonresident’s federal
based on commissions received or other results achieved attributable to Schedule D is excluded on the Exclusions and Adjustments to Capital
efforts expended in Grand Rapids. A nonresident insurance salesperson Gains or (Losses) schedule. Attach copies of federal Schedule K-1 (Form
paid sales commissions and renewal commissions should allocate 1120S). Use the Exclusions and Adjustments to Capital Gains or (Losses)
compensation on the following basis: Allocate commissions from life, health, schedule to compute exclusions and adjustments to capital gains. NOTE: A
accident and vehicle (auto) insurance based on the location (residence) of common error on a nonresident return is failure to complete the Exclusions
the purchaser. Allocate commissions from group insurance based on the and Adjustments schedule to exclude the capital loss carryover reported on
location of the group. Allocate commissions from fire and casualty insurance the taxpayer’s federal income tax return.
based on the location of the risk insured.
Line 8 – Other Gains (or Losses). A nonresident’s other gains and
Line 1 – Taxable wages. In Column A, you will report 100% of your losses are included in taxable income to the extent the gains or losses are
wages as shown on the federal return. In Column B, you will report wages from property located in Grand Rapids. Deferred other gains and losses
earned outside of the Grand Rapids city limits. If excluding wages in from installment sales and like-kind exchanges of property located in Grand
Column B, you will need to attach the WAGES AND EXCLUDIBLE Rapids are taxable in the year recognized on the taxpayer’s federal income
WAGES SCHEDULE (Attachment 2-1, typically found on page 3 of the tax tax return. Deferred other gains must be supported by attaching a copy of
form). Box 7 asks for the address of your actual work location – this is not federal Form 6252 and/or Form 8824. Flow through income or loss from an
always the same as the address on the W-2 form. In Box 7 you should S corporation reported on federal Form 4797 is excluded on the Exclusions
provide the location where you actually physically report to in order to and Adjustments to Other Gains and (Losses) schedule. Attach copies of
perform your work duties. If you work in multiple locations for an employer, federal Schedule K-1 (Form 1120S). Nonresidents reporting other gains
mark (x) the box on Line 6 and provide as much detail as possible. and losses must attach a copy of federal Form 4797. Use the Exclusions
and Adjustments to Other Gains and Losses schedule to compute
Please note that if you exclude 100% of your wages from an employer exclusions and adjustments to other gains and losses reported on the
that withheld tax for Grand Rapids, you will be asked to provide a federal income tax return. On line 4 of the schedule enter the total excluded
statement from the employer that no work duties were done in the other gains or losses and also enter this total on page 1, line 8, column B.
Grand Rapids city limits. If you will not be working in the city limits
for the employer, we also ask for the date that they stopped Line 9 – IRA Distributions. That portion of a premature IRA distribution
withholding tax for Grand Rapids. Grand Rapids tax should not be that was deducted from Grand Rapids taxable income in the current or a
withheld on wages earned outside of the Grand Rapids city limits by prior tax year (reported on Form 1099-R, box 7, distribution code 1) are
non-residents. You may need to file an updated W-4 Form with your taxable to a nonresident. IRA distributions received after age 59 ½ or
payroll department to indicate you do not live or work in the Grand described by Section 72(t)(2)(A)(iv) of the IRC are not taxable.
Rapids city limits. Employer verification may also be requested if you NONRESIDENTS (Continued)
indicate a large percentage of your time was spent working outside of
the Grand Rapids city limits.

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Line 10- Taxable Pensions and Annuities.  Premature pension plan 
distributions (those received by a nonresident prior to qualifying for 
retirement) are taxable to the same extent the normal wages from the 
employer are taxable. A nonresident remaining employed by the particular 
employer in Grand Rapids may not exclude amounts received from 
deferred compensation plans that let the employee set the amount to be 
put aside and do not set retirement age or requirements for years of 
service. These plans include, but are not limited to, plans under Sections 
401(k), 457 and 403(b) of the Internal Revenue Code (IRC): Amounts 
received before the recipient could retire under the plan provisions, 
including amounts paid on separation, withdrawal or discontinuance of the 
plan. Amounts received as early retirement incentives unless the incentives 
were paid from a pension trust. Form 1099-R, box 7, code 8, Excess 
contributions or excess deferrals taxable in current tax year are taxable to a 
nonresident to the same extent and on the same basis as the normal 
earning from the specific employer are taxable. Note: Form 1099-R, box 7, 
code P, reports excess contributions or excess deferrals taxable in the prior 
tax year and may require a nonresident to file an amended return for the 
prior tax year. See Line 10 under “Residents” for additional information on 
nontaxable pension and retirement benefits.  
 
Line 11 – Rental real estate, royalties, partnerships, S Corporations, 
trusts, etc. – PLEASE ATTACH FEDERAL SCHEDULE E.  All income 
reported on the federal Schedule E that comes from business activity in 
Grand Rapids or property located in Grand Rapids is taxable to 
nonresidents. When an estate or trust has taxable income in Grand Rapids, 
the estate or trust must file a return and pay tax on distributions to 
nonresidents and on undistributed taxable income. The following income 
reported on federal Schedule E is excludable: income from business 
activity or property outside Grand Rapids including royalty income upon 
which Michigan severance tax was paid; S corporation flow through income 
or loss reported on Schedule E; and income from estates and trusts. 
Explain all exclusions on the Exclusions and Adjustments to Income from 
Rental Real Estate, Royalties, Partnerships, S Corporations, Trusts, Etc. 
schedule. On line 6 of this schedule enter the total exclusions and 
adjustments; enter also on page 1, line 11, column C. 
 
Line 13 – Farm Income (or Loss).  A nonresident’s profit or loss from a 
farm are included in Grand Rapids income to the extent the profit or loss 
results from work done, services rendered or other activities conducted in 
Grand Rapids. The portion of the profit or loss reported on the Grand 
Rapids return is determined by use of the three factor Farm Allocation 
Percentage formula.  Sales of crops at the produce market, any of the 
farmer’s markets or a produce stand located in the city is Grand Rapids 
business activity and subjects the farm to Grand Rapids income tax. 
 
Line 16 – Other Income.  Any other income earned in the Grand Rapids 
city limits for which there is not a specific line is reported here.  Gambling 
income is not taxable to non-residents of Grand Rapids.  
 
Line 19 – Total Deductions.  A nonresident’s deductions are limited by 
the extent they relate to income taxable under the Grand Rapids Income 
Tax Ordinance. Nonresidents must allocate deductions the same way 
related income is allocated.  For example, if you contributed to an 
Individual Retirement Account (IRA) but only 50% of your wages are 
taxable to Grand Rapids, only 50% of the IRA deduction can be claimed.   
 
See GENERAL INSTRUCTIONS FOR ALL FILERS for mailing 
addresses

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CF-1040 GRAND RAPIDS 2022 22MI-GR-1040-1
INDIVIDUAL RETURN DUE APRIL 30, 2023
Taxpayer's SSN Taxpayer's first name Initial Last name RESIDENCE STATUS
Resident X 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
Married filing separately. Enter spouse's
Mark box (X) below if; City, town or post office State Zip code 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 2022
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
SEND 2. Taxable interest 2
COPY OF
PAGE 1 OF 3. Ordinary dividends 3
FEDERAL 4. Taxable refunds, credits or offsets of state and local income taxes 4 NOT TAXABLE
RETURN
5. Alimony received 5
6. Business income or (loss) (Attach copy of federal Schedule C) 6
7. Capital gain or (loss)
(Attach copy of fed. Sch. D) 7a. Mark if federal 7
Sch. D not required
8. Other gains or (losses) (Attach copy of federal Form 4797) 8
9. Taxable IRA distributions (Attach copy of Form(s) 1099-R) 9
10. Taxable pensions and annuities (Attach copy of Form(s) 1099-R) 10
11. Rental real estate, royalties, partnerships, S corporations, trusts,
etc. (Attach copy of federal Schedule E) 11
12. Subchapter S corporation distributions (Att. copy of fed. Sch. K-1) 12 NOT APPLICABLE
13. Farm income or (loss) (Attach copy of federal Schedule F) 13
SEND W-2 14. Unemployment compensation 14 NOT TAXABLE
FORMS 15. Social security benefits 15 NOT TAXABLE
16. Other income (Attach statement listing type and amount) 16
17. Total additions (Add lines 2 through 16) 17
18. Total income (Add lines 1 through 16) 18
19. Total deductions (Subtractions) (Total from page 2, Deductions schedule, line 7) 19
20. Total income after deductions (Subtract line 19 from line 18) 20
21. Exemptions (Enter the total exemptions, from Form CF-1040, page 2, box 1h, on line 21a and multiply this
number by $600 and enter on line 21b) $600 21a 21b
22. Total income subject to tax (Subtract line 21b from line 20) 22
23. Tax at {tax rate} (Multiply line 22 by non-resident rate for city .75% and enter tax on line 23b.
23a 23b
Payments GR tax withheld Other tax payments (est, extension, Credit for tax paid Total
24. and cr fwd, partnership & tax option corp) to another city payments
credits 24a 24b 24c & credits 24d
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 25b penalty 25c
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 GRAND RAPIDS, OR TO PAY WITH A DIRECT WITHDRAWAL mark (X) pay
MONEY tax due, line 31b, and complete lines 31c, d & e) RETURN 26
ORDER OVERPAYMENT 27. Tax overpayment (Subtract lines 23b and 25c from line 24d; choose overpayment options on lines 28 - 30) 27
Amount of Donation 1 Donation 2 Donation 3
28. overpayment Total
donated 28a 28b 28c donations 28d
29. Amount of overpayment credited forward to 2023 Amount of credit to 2023 >> 29
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
Direct deposit refund or 31a Refund 31c Routing
direct withdrawal payment (direct deposit) number
31. (Mark (X) appropriate box 31b Pay tax due 31d Account
31a or 31b and complete (direct withdrawal) number
lines 31c, 31d and 31e) 31e Account Type: 31e1. Checking 31e2. Savings
MAIL TO: GRAND RAPIDS INCOME TAX DEPARTMENT, PO BOX 106, GRAND RAPIDS, MI 49501-0106 Revised 01/13/2023

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                                                     Taxpayer's name                                                          Taxpayer's SSN
CF-1040, PAGE 2                                                                                                                                                                             22MI-GR-1040-2
CF 1040  PAGE 2                                                                                                                                                                                  c
EXEMPTIONS                                               Date of birth (mm/dd/yyyy)                                   Regular  65 or over   Blind
SCHEDULE                                  1a. You                                                                                                                                           1e. Enterboxesthecheckednumberon of  
                                          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                            FAILURE TO                                COLUMN E               COLUMN F
#                    T or S     SOCIAL SECURITY NUMBER EMPLOYER'S ID NUMBER                            EXCLUDED WAGES                          ATTACH W-2               GR TAX WITHHELD                         LOCALITY NAME
                                (Form W-2, box a)       (Form W-2, box b)                    (Attach Excluded Wages Sch)                                                (Form W-2, box 19)                   (Form W-2, box 20)
 1.                                                                                                                                         FORMS TO PAGE 1 
                                                                                                                                               WILL DELAY 
 2.                                                                                                                                         PROCESSING OF 
 3.                                                                                                                                           RETURN.  WAGE 
 4.                                                                                                                                            INFORMATION 
                                                                                                                                               STATEMENTS 
 5.                                                                                                                                            PRINTED FROM 
 6.                                                                                                                                              TAX 
 7.                                                                                                                                            PREPARATION 
                                                                                                                                               SOFTWARE ARE 
 8.                                                                                                                                         NOT ACCEPTABLE
9                    Totals (Enter here and on page 1; part-yr residents on Sch TC)                                                        << Enter on pg 1,ln 1, col B                              << 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 
 2.                  Self-employed SEP, SIMPLE and qualified plans  (Attach copy of Schedule 1 of federal return)                                                                         2 
 3.                  Employee business expenses  (Attach copy of CF-2106 and detailed list)                                                                                               3 
 4.                  Moving expenses  (Into city area only, Military ONLY)  (Attach copy of federal Form 3903)                                                                            4 
 5.                  Alimony paid  (DO NOT INCLUDE CHILD SUPPORT.  Attach copy of Schedule 1 of federal return)                                                                           5 
 6.                  Renaissance Zone deduction  (Attach Schedule RZ OF 1040)                                                                                                             6 
 7.                            Total deductions (Add line 1 through line 6, enter total here and on page 1, line 19)                                                                      7 
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                        Daytime phone number                        If deceased, date of death 

                     Some cities are using new communication methods. If your City participates and you would like email notifications regarding important changes and Income Tax related information please provide
                     your email address.  No City will email you asking for your social security number.             Email
                     SIGNATURE OF PREPARER OTHER THAN TAXPAYER                                                                              Date (MM/DD/YY)             PTIN, EIN or SSN
                                                                                                                                                                        Preparer's phone no.
            S        FIRM'S NAME (or yours if self-employed), ADDRESS AND ZIP CODE                                                                                                      NACTP    
  PREPARER'          SIGNATURE                                                                                                                                                          software    
                                                                                                                                                                                        number 
                                                                                                                                                                                                                Revised 10/15/2020

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Taxpayer's name                                                Taxpayer's SSN
                                                                                                                     2022 Grand Rapids
WAGES AND EXCLUDIBLE WAGES SCHEDULE - CF-1040, PAGE 1, LINE 1, COLUMN B                                                                                                      Attachment 2-1
All W-2 forms must be attached to page 1 of the return                                                                                                                       Revised 06/15/2017
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 CF-1040, page 2, Excluded Wages and Tax Withheld Schedule and the total amount of excludible wages is reported on Form CF-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 Grand 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 
Grand Rapids
20. Total excludible wages (Line 17 plus line 
18; Enter here and  on  CF-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 CF-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 CF-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 CF-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.

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Taxpayer's name                                        Taxpayer's SSN
                                                                                  2022 Grand Rapids
WAGES AND EXCLUDIBLE WAGES SCHEDULE - CF-1040, PAGE 1, LINE 1, COLUMN B                                                                                                      Attachment 2-2
All W-2 forms must be attached to page 1 of the return                                                                                                                       Revised 06/15/2017
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 CF-1040, page 2, Excluded Wages and Tax Withheld Schedule and the total amount of excludible wages is reported on Form CF-1040, page 1, line 1, column B. 
WAGES, ETC.                                         Employer (or source) 4        Employer (or source) 5        Employer (or source) 6
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 Grand 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) 4        Employer (or source) 5        Employer (or source) 6
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) 4        Employer (or source) 5        Employer (or source) 6
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 
Grand Rapids
20. Total excludible wages (Line 17 plus line 
18; Enter here and  on  CF-1040, page 2, 
Excluded Wages schedule) 
21. Total taxable wages (Line 8 plus line 9  
less line 20)

FAILURE TO ATTACH ALL FORMS W-2 OR PROPERLY COMPLETE AND ATTACH THIS SCHEDULE WILL DELAY PROCESSING OF RETURN.

- 8 -

Taxpayer's name                                        Taxpayer's SSN
                                                                                  2022 Grand Rapids
WAGES AND EXCLUDIBLE WAGES SCHEDULE - CF-1040, PAGE 1, LINE 1, COLUMN B                                                                                                      Attachment 2-3
All W-2 forms must be attached to page 1 of the return                                                                                                                       Revised 06/15/2017
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 CF-1040, page 2, Excluded Wages and Tax Withheld Schedule and the total amount of excludible wages is reported on Form CF-1040, page 1, line 1, column B. 
WAGES, ETC.                                         Employer (or source) 7        Employer (or source) 8        Employer (or source) 9
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 {CN}
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) 7        Employer (or source) 8        Employer (or source) 9
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) 7        Employer (or source) 8        Employer (or source) 9
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 
{CN}
20. Total excludible wages (Line 17 plus line 
18; Enter here and  on  CF-1040, page 2, 
Excluded Wages schedule) 
21. Total taxable wages (Line 8 plus line 9  
less line 20)

FAILURE TO ATTACH ALL FORMS W-2 OR PROPERLY COMPLETE AND ATTACH THIS SCHEDULE WILL DELAY PROCESSING OF RETURN.

- 9 -

Taxpayer's name                                        Taxpayer's SSN
                                                                                   2022 Grand Rapids
WAGES AND EXCLUDIBLE WAGES SCHEDULE - CF-1040, PAGE 1, LINE 1, COLUMN B                                                                                                      Attachment 2-4
All W-2 forms must be attached to page 1 of the return                                                                                                                       Revised 06/15/2017
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 CF-1040, page 2, Excluded Wages and Tax Withheld Schedule and the total amount of excludible wages is reported on Form CF-1040, page 1, line 1, column B. 
WAGES, ETC.                                         Employer (or source) 10        Employer (or source) 11        Employer (or source) 12
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 Grand 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) 10        Employer (or source) 11        Employer (or source) 12
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) 10        Employer (or source) 11        Employer (or source) 12
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 
Grand Rapids
20. Total excludible wages (Line 17 plus line 
18; Enter here and  on  CF-1040, page 2, 
Excluded Wages schedule) 
21. Total taxable wages (Line 8 plus line 9  
less line 20)

FAILURE TO ATTACH ALL FORMS W-2 OR PROPERLY COMPLETE AND ATTACH THIS SCHEDULE WILL DELAY PROCESSING OF RETURN.

- 10 -

GRAND RAPIDS INCOME TAX DEPT. 
300 Monroe Ave NW 
Grand Rapids, MI  49503 

PLEASE REMEMBER TO: 

 Sign your return.  If a joint return, both spouses must sign even if only one had income subject to
  Grand Rapids income tax.

 Attach copies of Form(s) W-2.  If you are claiming a credit for Grand Rapids withholding, the locality
  name on your W-2 must be Grand Rapids.

PDF file checksum: 2506265707

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