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                                                                   2022 

                                        Individual Tax Return           Form SF-1040 

                           Returns and Payments due                     May 01  , 2023 

Remittance: 
Mail completed returns and payments to:                                 Due Date and Extensions: 
                                                                        Returns and payments of any balance due are due on or 
                                                                        before May 01, 2023. If the due date falls on a weekend or a 
City of Springfield Income Tax Department 
601 Avenue A                                                            holiday, the due date becomes the next business day. The due 
Springfield, MI 49037-7774                                              date of the annual income tax return may be extended for a 
                                                                        period not to exceed six months. Applying for a federal 
Make checks and money orders payable to:                                extension does not automatically satisfy the requirement 
City of Springfield. No payment is necessary if tax due is less         for filing a Springfield extension. Application for an 
than $1.00.                                                             extension must be filed with the city and tentative tax due must 
                                                                        be paid (MCL 141.664). Filing an extension with payment is 
For faster processing, you may also your completed return and           not a substitute for making estimated tax payments. An 
upload it using our upload form and/or pay tax due on the               extension does not extend the time for paying tax due. 
income tax page of our website at www.springfieldmich.com.  
                                                                        Amended Returns: 
                                                                        File amended returns using form SF-1040X, available on our 
Who must file a return: 
Any person having income taxable to the City of Springfield in          website. If a change on your federal return affects Springfield 
excess of the personal and dependent exemption amounts                  taxable income, you must file an amended return within 90 
must file a return, even if you do not file a state or federal tax      days of the change. All schedules supporting the changes, as 
return. You are required to file a return and pay tax due even if       well as an explanation for each change, should accompany the 
your employer did not withhold Springfield tax from your                filing. 
paycheck. If you work for an employer that does not withhold 
                                                                        Charges for Late Payments 
Springfield tax from your paycheck, you may be required to 
                                                                        All taxes remaining unpaid after the original due date of the 
pay estimated income tax payments (See “Estimated Tax 
                                                                        return are subject to interest at the rate of 1% above the 
Payments” section below).                                               adjusted prime rate on an annual basis, and to penalty at a 
Estimated Tax Payments                                                  rate of 1% per month, not to exceed 25% of the tax. The 
When your balance due in excess of withholding and credits              minimum charge for penalty and interest is $2.00. 
exceeds $100, you may be required to make quarterly 
                                                                        Return Assistance: 
estimated tax payments. Additional instructions as well as 
                                                                        For questions not answered in the instructions, call us at 
vouchers to remit with your payment can be found on our 
                                                                        (269) 965-8324, e-mail us at incometax@springfieldmich.com,
website. Quarterly payments are due 4/30, 6/30, and 9/30 of 
                                                                        or visit our office at the address listed above.
the tax year, and 1/31 of the following year. Failure to make 
required estimated tax payments or underpayment of 
estimated tax payments will result in assessment of 
penalty and interest. If you have made estimated tax 
payments and do not owe more tax for the year, you still must 
file a tax return. 

            For additional forms or to pay tax due online, visit our website at www.springfieldmich.com. 
                           We accept credit and debit cards, as well as e-checks.  
             A 3% fee (min of $1.50) applies to debit and credit cards, however e-checks are free!

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2022 RETURN REMINDERS refund is due and the check is to be made payable to someone
other than the surviving spouse, a letter of explanation must be
Itemized Deductions on Federal Return: attached to the return with a copy of the federal Form 1310 and
If you itemized your deductions on your federal return, please a copy of the death certificate.
mark the box at the top of the first page of your city return. If
the box is not marked, we will assume that you did not itemize
and used the standard deduction on your federal return. TAXABLE INCOME

RESIDENTS
Non-Resident Wage Allocation – Working from Home in 2022:
Springfield residents are required to report the following types of
Non-residents who worked remotely for hours approximating
income, regardless of where the income is earned. These types of
their regular shift may be eligible to exclude the portion of
income are taxable to the City of Springfield to the extent and on
their income earned while working remotely if the temporary
the same basis as income subject to taxation by the Internal
work location was outside of Springfield. Calculate your
Revenue Service, unless otherwise noted. There are very few
exclusion on the wages and excludable wages schedule
instances in which adjustments/exclusions from amounts
and attach a letter from your employer confirming that you
worked remotely, or your allocation will be denied. Form listed on your federal return will apply to residents.

CF-COV that has been used previously is no longer required 1. Wages, salaries, bonuses, commissions, fees, tips, gratuities,
and has been eliminated this year. vacation pay, sick pay, severance pay, and disability pay.
2. Compensation that is received in the form of merchandise or
services (The fair market value must be determined and
reported).
COMPLETING YOUR RETURN
3. Self-employment income as an unincorporated business or
profession, no matter where the business is located.
Determining Residency:
Resident: A person who has established a fixed home for any 4. Rents, royalties, estates, trusts, patents, and copyrights.
period of time during the year in the City of Springfield city 5. Alimony (only payments received and required under a
limits. divorce or separation instrument that was executed on or
before 12/31/2018).
Non-Resident: A person who has established a fixed home 6. Interest earned from bank or credit union accounts, savings
outside the City of Springfield city limits but earned income in and loan associations, land contracts, notes, and bonds.
the City of Springfield. 7. Dividends, including distributions from Sub Chapter S
Corporations, taxed as dividends by the Internal Revenue
Part-Year Resident: If you were both a resident and non- Service.
resident during the year, complete Schedule SF-PY to 8. Sales & Exchanges of Property (Capital gains and losses).
determine taxable income. Skip lines 1-22 on the tax form. 9. Premature distributions from: IRA’s, employee savings plans,
stock purchases, profit sharing plans, and deferred
Married with Different Residency Status: If you were compensation.
married and had a different residency status than that of your 10. Partnerships: All partnerships located inside the City of
spouse, please file separate returns using the “Married Filing Springfield must file an annual Informational City of Springfield
SF-1065 Partnership Return. Attach federal schedule E and
Separately” status, even if your federal return was filed jointly.
all supporting schedules. In addition, each individual of the
Married Persons – Joint or Separate Returns: partnership is required to report as income on their City of
Married persons may file either a joint or separate return. Springfield SF-1040 Individual Return, their distributive share
of the net profits or losses of the partnership. If you are a
Joint return: Both names and social security numbers must be Springfield resident and had income from a partnership
listed on your return. Taxable income of both husband and wife located outside the City of Springfield, you must attach a copy
must be included. Both husband and wife must sign the return. of your federal Schedule K-1.
11. Farm Income.
Separate Returns: Each spouse must complete separate filing 12. Subchapter S Corporation distributions (If you are a
status information on the return. This includes spouse’s name shareholder in a corporation that has elected to file under
and social security number. Dependents can only be claimed Subchapter S of the Internal Revenue Code, you are not
by one spouse who is entitled to claim each dependent under required to report any distributed income from the federal
the Internal Revenue Code. If you file separately, you may not Schedule K-1 page 1, nor may you deduct your share of any
claim an exemption for your spouse. loss or other deductions distributed by the corporation).
13. Gambling and lottery winnings.
Deceased Taxpayer: 14. All other income subject to tax by the IRS that is not
A return for a person who died during the year should be filed specifically excluded under the City of Springfield Income Tax
on the same basis as if the person was still living. Please Ordinance.
attach a copy of the death certificate or Federal Form 1310. If a

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NON-RESIDENTS
Non-residents are required to report income or losses earned NON-DEDUCTIBLE ITEMS
within, derived from, or attributable to City of Springfield sources.
List federal data under Column A on the tax form and then list the The City of Springfield does not allow deductions for items such as
amount not applicable to Springfield in “Column B”. Subtract taxes paid, interest, medical expenses, charitable contributions,
Column B from Column A and list the result in Column C. casualty and theft losses, etc. In addition, the following federal
adjustments are not deductible: educator expenses; certain
1. Compensation received for all work performed within the business expenses of reservists, performing artists, and fee-basis
City of Springfield city limits. government officials; health savings account deduction; deductible
2. Operation of a business or profession attributable to any part of self-employment tax; self-employed health insurance
business activity conducted within the City of Springfield deduction; penalty for early withdrawal of savings; student loan
city limits. interest deduction; tuition and fees; and domestic production
3. Rental of real and tangible property, and principle activities deduction.
payments on land contract if the property is located within
the City of Springfield city limits.
EXEMPTIONS
4. Capital gains and losses from the sale or exchange of
real and tangible property located in the City of
Springfield city limits. 1. A taxpayer may deduct $750 per exemption.
5. Premature distributions from a retirement or deferred 2. One exemption may be claimed for yourself (even if your
compensation plan from an employer located within the exemption is claimed on another return), your spouse, and
City of Springfield city limits. each dependent.
3. Additional exemptions may be claimed if the taxpayer qualifies
under any of the qualifying categories (only 1 exemption is
NON-TAXABLE INCOME allowed per category unless otherwise noted):

The following kinds of income are non-taxable for both residents Category 1: Age 65 or older by December 31, 2022 or
and non-residents by the City of Springfield. disabled. Note: If you claim this exemption, you may not claim
an additional exemption for totally and permanently disabled.
1. Gifts, inheritances, and bequests. However, if you are blind, deaf, hemiplegic, paraplegic, or
2. Social Security, qualifying pensions / annuities (including quadriplegic, you may claim an additional exemption.
disability pensions and railroad retirement act benefits) and
IRA distributions received after reaching age 59 ½. Category 2: Blind, hemiplegic, paraplegic, quadriplegic.
3. Unemployment compensation, worker’s compensation, and
welfare benefits. Category 3: Deaf, as defined in Section 393.502 of the
4. Child support. Michigan Complied Laws.
5. Alimony and separate maintenance payments received
under a divorce or separation instrument executed after 4. If an individual has taxable income and is claimed as a
12/31/18. dependent on another person’s federal income tax return,
6. Insurance payments in which the taxpayer paid policy they may claim a personal exemption on their own City of
premiums. (Payments from a health and accident policy paid Springfield tax return.
by an employer are taxed the same as under the Internal
Revenue Code).

7. Dividends received from an insurance policy when these are a
refund of premiums paid. Any excess amount paid to you in
excess of premiums paid is taxable.
8. Interest from obligations of the United States, cities, or any
other government unit of the United States.
9. State and local income tax refunds.
10. Compensation received for service in the Armed Forces of the
United States, including Active Duty, Reserve, and National
Guard (civilian pay is taxable).

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Line 5 – Alimony received on separation instruments executed
FORM SF-1040 LINE INSTRUCTIONS . For part-year residents, amount is
on or before 12/31/18
Please print or type all requested information. pro-rated for time of residency. *Per Internal Revenue
Code, alimony and separation maintenance payments
Print clearly your Name(s), complete address (if using a P.O. Box, received are no longer taxable or deductible on divorce or
you must also list your physical address), and social security separation instruments executed after 12/31/18.
number(s).
Line 6 – Business income from self-employment. Attach a copy
Check appropriate box to indicate your residency status. of your federal Schedule C (all pages). Non-residents,
use business allocation on page 11.
PART-YEAR RESIDENTS: Complete the included Schedule TC to
properly allocate your income before completing form SF-1040. Line 7 – Capital gains or losses reported on your federal return.
This form must be attached to your return. Note: The only exception is the sale of property
purchased prior to January 1, 1989. Gains or losses on
Check appropriate box to indicate your filing status (if married filing property purchased prior to January 1, 1989 must be
separately, list spouse’s full name and social security number). determined by one of the following methods:

EXEMPTIONS: Complete the exemption schedule found on page -The basis may be the adjusted fair market value of the
8 and include with your tax return. property on January 1, 1989 or;

WAGES: Complete the included Wages and Excludable Wages -Divide the number of months the property has been held
Schedule before you begin completing your city tax return. If you since January 1, 1989 by the total number of months the
are a resident or if all of your non-resident income is taxable to property was held. Apply this fraction to the total gain or
Springfield, stop at line 10 and write the total of all lines 8 & 9 on loss as reported on your federal tax return.
line 24 and on line 1 columns A & C of SF-1040. For non-residents You must attach federal Schedule D.
& part-year residents that need to exclude or allocate income that
is not taxable to Springfield, continue with the lower portion of the Line 8 – Other gains or losses on your federal return reported on
form, following instructions on each line. Allocations or federal Form 4797. You must attach federal Form
exclusions of income from employers located in Springfield 4797.
will require a letter from your employer stating time worked in
and out of the city to be attached to your return. Failure to Line 9 – Taxable IRA distributions reported on your federal
attach may result in your allocation being denied. return. Exclude any normal distributions taken after you
have reached age 59 ½. You must attach a copy of
NON-RESIDENT WAGE AND/OR BUSINESS INCOME form 1099-R. To determine whether your distribution is
ALLOCATION: See worksheet found on page 11. taxable or not, refer to the code in box 7 on your 1099-R
for that distribution and compare it with the list of common
*See pages 2 & 3 to determine what is taxable as a resident codes below:
and non-resident. Use Column A to list federal return data, list
any adjustments or exclusions in Column B, then subtract Code 1: Early distribution – taxable on city return, do not
Column B from Column A and enter the result in Column C. exclude.
Remember, there are very few adjustments/exclusions that Code 2: Early distribution – exception applies, not
are allowable on a resident tax return. Column B will most taxable on city return, exclude.
often be used on a non-resident tax return. Code 4: Death – not taxable if the decedent is a spouse.
Exclude only if the decedent was your spouse.
INCOME Code 7: Normal distribution – not taxable on city return,
exclude.
Line 1 – Wages, salaries, tips, etc. Include the total of wages
from box 1 of applicable W-2’s and the Wages and Line 10 – Taxable pension distributions reported on your federal
Excludable Wages schedule. Copies of W-2’s must be return Exclude any normal distributions taken after you
attached to your return. have reached age 59 ½. You must attach a copy of
Line 2 – Interest income taxable on your federal tax return. form 1099-R. To determine whether your distribution is
taxable or not, refer to the code in box 7 on your 1099-R
Attach federal Schedule B if applicable.
for that distribution and compare it with the list of common
Line 3 – Dividend income taxable on your federal tax return. codes in the instructions for line 9 above.
Attach federal Schedule B if applicable.
Line 11 – Rental real estate, royalties, partnerships,
Line 4 – Tax refunds, credits, or offsets. NOT TAXABLE on your S corporations, trusts, etc. reported on your federal
city return- Exclude all, no explanation needed. return. You must attach a copy of federal Schedule E.

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Line 12 – S Corporation distribution. Enter cash or property Line 4 – Moving expenses (moving into Springfield). Moving
distributions from S Corporations from page 2 of the expenses for active duty military members that moved
federal schedule K-1. The Springfield City income tax into Springfield during the year and qualify for a
ordinance does not recognize Subchapter S status, deduction from gross income on their federal return are
however distributions from an S Corporation are taxable eligible for a deduction on their Springfield return. You
as if paid by a regular corporation as dividends. You must attach federal Form 3903. *See instructions for
must attach a copy of federal Schedule K-1. federal Form 3903 for more info or to determine if you
qualify for this deduction.
Line 13 – Farm income or loss. You must attach a copy of
federal Schedule F. Line 5 – Alimony paid on separation instruments executed on
or before 12/31/18. *Per Internal Revenue Code, alimony
Line 14 – Unemployment compensation – NOT TAXABLE on your and separation maintenance payments received are no
city return. longer taxable or deductible on divorce or separation
instruments executed after 12/31/18. For part-year
Line 15 – Social security benefits – NOT TAXABLE on your city residents, deduction is pro-rated for time of residency.
return.
Line 6 – Other deduction not listed but allowed per the City Income
Line 16 – Other income or loss as reported on your federal return, Tax Ordinance. You must attach documentation
you must include supporting documents listing the type of supporting your deduction or it will be disallowed.
income or loss and the amount.
PAYMENTS AND CREDITS
For the remaining lines, follow the instructions listed on each
line on the tax form. Line 24a – Tax withheld by your employer(s). Enter the total
Springfield tax withheld from all W-2 forms. You must
DEDUCTIONS SCHEDULE (SECOND PAGE OF TAX FORM) attach copies of all W-2 forms.

*All deductions are limited to the extent that they apply to Line 24b – Enter any estimated payments paid for 2022, payments
income taxable to the City of Springfield. made with an extension, and any credits carried forward
from your 2021 Springfield return.
*Part-Year residents must allocate deductions based on days
of residency as they would allocate income. Line 24c – Credit for taxes paid to another city while a resident of
Springfield. You must attach a copy of the other city
Line 1 – Individual retirement account (IRA) deduction. This return. See worksheet on page 11 to calculate this credit.
deduction is limited to the amount allowed on your federal
return and must be contributions to an IRA with after-tax Line 24d – Total payments and credits: Add lines 24 a through c.
dollars. To compute this deduction, multiply the amount
deducted on your federal return by the percentage of your *If line 23 is larger than line 24d, go to line 26. If line 24d is
income that is taxable to the City of Springfield. You larger than line 23, go to line 27.
must attach a copy of Schedule 1 of your federal
return. Line 26 – Total tax due: Subtract line 24d from line 23. This is
your tax due to pay with your return. Payments and
Line 2 – Self-employed SEP, SIMPLE, and qualified plans. You returns are due April 30th.
must attach a copy of Schedule 1 of your federal
return. Line 27 – Overpayment: Subtract line 23 from 24d. Enter the total
on line 34 if you would like your overpayment to be
Line 3 – Employee business expenses. This includes ordinary, credited forward to 2023. Enter the total on line 35 if you
necessary, and unreimbursed expenses incurred in the would like your overpayment to be refunded to you.
performance of an employee’s job to the extent that these
expenses are related to your income taxable to The City *Complete lines 28 through 31 to indicate how you would like
of Springfield. Your deduction is limited to the following: to receive your refund of overpaid tax.
expenses of travel, meals, and lodging while away from
home for work, expenses of an outside sales person *Make sure to double check your completed City of Springfield tax
while away from their employer’s place of business, return for accuracy and legibility. Also, make sure to attach all
expenses of transportation, and reimbursed expenses required supporting documents, as well as page 1, schedule
which have been included in your W-2 income. You must 1, and schedule 2 of your federal income tax return (See
complete and attach form SF-2106 (available on our instructions for each line if you are not sure which
website and in our office) and include a list detailing the attachments are required).
expenses you are deducting. Failure to attach either of
these will result in your deduction being disallowed. Did you sign your return?

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SF-1040 SPRINGFIELD 2022
INDIVIDUAL RETURN DUE May 01, 2023
Taxpayer's SSN Taxpayer's first name and initial Last name RESIDENCE STATUS
Resident Nonresident Part- year
resident
Spouse's SSN If Joint return, spouse's first name and 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
Mark box (X) below if form attached City, town or post office State Zip code Married filing separately. Enter spouse's SSN in
Spouse's SSN box and Spouse's full name here.
Federal Form 1310
Foreign country name Foreign province/county Foreign postal code
Itemized deductions on your
Federal tax return for 2022 Spouse's full name if married filing separately
ROUND ALL FIGURES TO NEAREST DOLLAR Column A Column B Column C
INCOME (Drop amounts under $0.50 and increase Federal Return Data Exclusions/Adjustments Taxable Income
amounts from $0.50 to $0.99 to next dollar)
1. Wages, salaries, tips, etc. (W-2 forms must be attached) 1.
ATTACH 2. Taxable interest 2.
W-2
FORMS 3. Ordinary dividends 3.
HERE
4. Taxable refunds, credits or offsets of state and local income taxes 4. NOT TAXABLE
5. Alimony received 5.
6. Business income or (loss) (Attach copy of federal Schedule C) 6.
7. Capital gain or (loss) 7a. Mark if federal
(Attach copy of fed. Sch. D) Sch. D not required 7.
ATTACH 8. Other gains or (losses) (Attach copy of federal Form 4797) 8.
COPY OF 9. Taxable IRA distributions (Attach copy of Form(s) 1099-R) 9.
PAGE 1
& 2 OF 10. Taxable pensions and annuities (Attach copy of Form(s) 1099-R) 10.
FEDERAL
RETURN 11. Rental real estate, royalties, partnerships, S corporations,
trusts, etc. (Attach copy of federal Schedule E 11.
12. Subchapter S corporation distributions (Attach federal Sch K-1) 12. NOT APPLICABLE
13. Farm income or (loss) (Attach copy of federal Schedule F) 13.
14. Unemployment compensation 14. NOT TAXABLE
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.
Round all 19. Total deductions (Subtractions) (Total from page 2, Deductions schedule, line 7) 19.
figures to
the 20. Total income after deductions (Subtract line 19 from line 18) 20.
nearest
dollar 21. Exemptions number by $750 and enter on line 21b) 21a 21b.
(Enter the total exemptions, from Form SF-1040, page 2, box 1h, in line 21a and multiply this

22. Total income subject to tax (Subtract line 21b from line 20) 22.
(Multiply line 22 by Springfield resident tax rate of 1% (0.01) or nonresident tax rate of 0.5%
23. Tax rate (0.005) and enter tax on line 23b, or if using Schedule TC to compute tax, check box 23a and enter
tax from Schedule TC, line 23d) 23a. 23b.
Springfield tax withheld Other tax payments (est, ext, cr fwd, Credit for tax paid to another city
24. Payments partnership & taxoption corp)
and credits 24a. 24b. 24c. 24d.
Interest and penalty for: failure to make Interest Penalty
25. estimated tax payments, underpayment
ENCLOSE of estimated tax, or late payment of tax 25a. 25b. 25c.
CHECK 26. Amount you owe (Add lines 23b and 25c, and subtract line 24) MAKE CHECK OR MONEY ORDER PAY WITH 26.
OR TAX DUE PAYABLE TO: CITY OF SPRINGFIELD, OR TO PAY WITH A DIRECT WITHDRAWAL mark (X) pay RETURN
MONEY tax due, line 31b, and complete lines 31c, d & e (please allow approx. 8 weeks to process)
ORDER OVERPAYMENT 27. Tax overpayment (Subtract lines 23b and 25c from line 24d; choose overpayment options on lines 28 - 30) 27.
City Operations N/A N/A
28. Donation Total
28a. 28b. 28c. donation 28d.
29. Amount of overpayment credited forward to 202 2 Amount of credit to 202 3>> 29.
Amount of overpayment refunded (Line 27 less lines 28d and 29) (For refund to be directly deposited to
30. your bank account mark refund box, line 31a, and complete line 31c, d & e) Refund amount >> 30.
31a. Refund 31c. Routing
Direct deposit refund or (direct deposit) number
direct withdrawal payment
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: Checking Savings

MAIL RETURNS & PAYMENTS TO CITY: OF SPRINGFIELD INCOME TAX DEPT, 601 AVENUE A, SPRINGFIELD, MI 49037
OR
SCAN AND UPLOAD COMPLETED RETURNS AND SUPPORTING DOCUMENTS ON OUR WEBSITE AT WWW.SPRINGFIELDMICH.COM
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SF-1040, PAGE 2 - Taxpayer's name Taxpayer's SSN

EXEMPTIONS Date of birth (mm/dd/yyyy) Regular 65 or over Blind Deaf Disabled
SCHEDULE 1a. You 1e. Enter the number of boxes
9 checked on lines 1a and 1b
1b. Spouse
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 the number of
dependent children listed
1. on line 1d
2.
3. 1g. Enter the number of
4. other dependents listed
on line 1d
5.
6. 1h. Total exemptions (Add
7. lines 1e, 1f and 1g;
enter here and also on
8. page 1, line 21a)
EXCLUDED WAGES AND TAX WITHHELD SCHEDULE (See instructions. Resident wages generally not excluded)
COL. A COLUMN B COLUMN C COLUMN D COLUMN E COLUMN F
W2 SOCIAL SECURITY NUMBER EMPLOYER'S ID NUMBER EXCLUDED WAGES FAILURE TO SF TAX WITHHELD LOCALITY NAME
# T or S (Form W2, box a) (Form W2, box b) (Attach Excluded Wages Sch) ATTACH W-2 FORMS (Form W2, box 19) (Form W2, box 20)
1. TO PAGE 1 WILL
DELAY PROCESSING
2. OF RETURN.
3.
4. WAGE
INFORMATION
5. STATEMENTS
6. PRINTED FROM TAX
PREPARATION
7. SOFTWARE ARE
8. NOT ACCEPTABLE.
11. 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, line 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 (See instructions and attach copy of CF-2106 and detailed list) 3
4. Moving expenses (Into Springfield area only) (Attach copy of federal Form 3903) 4.
5. Alimony paid (DO NOT INCLUDE CHILD SUPPORT. Attach copy of Schedule 1 of federal return) *SEE INSTRUCTIONS PG 5 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 the 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

If you authorize the city to email you regarding tax related issues and/or Taxpayer Email
notificaitons, please include your email address. The city WILL NOT include
sensitive tax information or ask for your Social Security number via email.
SIGNATURE OF PREPARER OTHER THAN TAXPAYER Date (MM/DD/YY) PTIN, EIN or SSN Preparer's phone number

FIRM'S NAME (or yours if self-employed), ADDRESS AND ZIP CODE NACTP
PREPARER'S SIGNATURE software
number

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 Taxpayer's name                                                               Taxpayer's SSN 
                                                                                                                            2021 SPRINGFIELD                         Attachment 2

 WAGES AND EXCLUDABLE WAGES SCHEDULE - SF-1040, PAGE 1, LINE 1 - USE ONLY IF EXCLUDING ANY PORTION OF
 WAGES LISTED ON YOUR FEDERAL RETURN
Use this form to provide details for all Forms W-2 and all other wage income reported on federal Forms 1040 (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 excludable (nontaxable) wages included in total 
wages reported on your federal tax return (Form 1040, line 1). Excludable wages for each employer are also reported on Form SF-1040, page 2, Excluded Wages and Tax Withheld Schedule and the 
total amount of excludable wages is reported on Form SF-1040, page 1, line 1, column B .
              WAGES,  ETC.                   Employer (or source) 1             Employer (or source) 2                      Employer (or source) 3              Employer (or source) 4 
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                             From To

  .6 Mark (X) box If you work at multiple 
     locations in and out of Springfield. 
     Address of work station (Where you 
     actually work, not address on Form 
 7.  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)

 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              Employer (or source) 4 
 For use by nonresidents or part-year residents who worked both in and out of Springfield for the employer while a nonresident. Part- year residents working both in and out while  a 
nonresident must use the wage allocation to determine wages earned in Springfield 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 Springfield should skip this Nonresident Wage Allocation section for that employer as all of their wages are taxable.
     Enter actual number of days or hours 
 11. on job for employer during period (Do 
     not include weekends you didn't work)
     Vacation, holiday and sick days or   
 12. hours included in line 11, only if work 
     performed in & out of Springfield
 13. Actual number of days or hours 
     worked  (Line 11 less line 12)
 14. Enter actual number of days or 
     hours worked in Springfield
     Percentage of days or hours 
 15. worked in Springfield (Line 14                                        %%%%
     divided by lin 13). Default is 100%
     Wages earned in Springfield (Total  
 16. of lines 8 & 9 multiplied by line 15; 
     part-year res use only the portion of 
     wages earned while a nonres)
      EXCLUDABLE  WAGES                      Employer (or source) 1             Employer (or source) 2                      Employer (or source) 3              Employer (or source) 4 
     Enter nonresident excludable 
 17. wages (Total of lines 8 and 9 less 
     line 16)
 18. Enter resident excludable wages
     Enter reason excludable wages 
 19. reported on lines 17 and/or 18 
     are not taxable by Springfield
     Total excludable wages (Line 17 plus  
 20. line 18; Enter here and on SF-1040, 
     page 2 Excluded Wages schedule)
 21. Total taxable wages (Line 8 plus 
     line 9 less line 20)
     Total wages (Add lines 8 and 9 for all employers and other sources; must 
 22. equal amount reported on Form SF-1040, page 1, line 1, column A; Part-year 
     residents must equal amount reported on Schedule TC, line 1, column A)
 23. Total excludable wages from all employers and other sources (Add line 20 for all columns; enter here and also on  
     Form SF-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 SF-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
202 2SPRINGFIELD
SCHEDULE TC, PART-YEAR RESIDENT TAX CALCULATION - SF-1040, PAGE 1, LINES 23a AND 23b Attachment 1
A part-year resident is required to complete and attach this schedule to the Springfield return
1. Box A to report dates of residency of the taxpayer and spouse during the tax year.
2. Box B to report the former address of the taxpayer and spouse.
3. Column A to report all income from their federal income tax return.
4. Column B to report all income taxable on their federal return that is not taxable to Springfield.
5. Column C to report income taxable as a resident and compute tax due on this income at the resident tax rate.
6. Column D to report income taxable as a nonresident and compute tax due on this income at the nonresident tax rate.
A. PART-YEAR RESIDENCY PERIOD From To B. PART-YEAR RESIDENT'S FORMER ADDRESS
Taxpayer Taxpayer
Spouse Spouse
Column A Column B Column C Column D
INCOME Federal Return Data Exclusions and Adjustments Taxable Resident Income Taxable Nonresident Income
1. Wages, salaries, tips, etc. (Attach Form(s) W-2) 1.
2. Taxable interest 2. NOT TAXABLE
3. Ordinary dividends 3. NOT TAXABLE
4. Taxable refunds, credits or offsets 4. NOT APPLICABLE NOT TAXABLE
5. Alimony received 5.
6. Business income or (loss) (Att. copy of fed. Sch. C) 6.
7. Capital gain or (loss) 7a. Mark if Sch D 7b.
(Att. copy of Sch. D) not required
8. Other gains or (losses) (Att. copy of Form 4797) 8.
9. Taxable IRA distributions 9.
10. Taxable pensions and annuities (Att. Form 1099-R) 10.
11. Rental real estate, royalties, partnerships, S corps, 11.
trusts, etc. (Attach copy of federal Sch. E)

12. Subchapter S corporation distributions 12.
(Attach federal Sch. K-1)
13. Farm income or (loss) (Att. copy of federal Sch. F) 13.
14. Unemployment compensation 14. NOT APPLICABLE NOT TAXABLE
15. Social security benefits 15. NOT APPLICABLE NOT TAXABLE
16. Other income (Att. statement listing type and amt) 16.
17. Total additions (Add lines 2 through 16) 17.
18. Total income (Add lines 1 through 16) 18.
DEDUCTIONS SCHEDULE See instructions. Deductions must be allocated on the same basis as related income.
1. IRA deduction (Attach copy of federal 1.
Schedule 1 & evidence of payment)

2. Self-employed SEP, SIMPLE and qualified 2.
plans (Attach copy of federal Schedule 1)

3. Employee business expenses (See instructions 3.
& attach copy of federal Form 2106)

4. Moving expenses (Into Battle Creek area 4.
only) (Attach copy of federal form 3903)

5. Alimony paid (DO NOT INCLUDE CHILD 5.
SUPPORT). (Attach copy of federal Schedule 1)
6. Renaissance Zone deduction (Attach Sch. RZ) 6.
19. Total deductions (Add lines 1 through 6) 19.
20a. Total income after deductions (Subtract line 19 from line 18) 20a.
20b. Losses transferred between columns C and D (If line 20a is a loss in either column C or D, see instructions) 20b.
20c. Total income after adjustment (Line 20a less line 20b) 20c.
(Enter the number of exemptions from Form SF-1040, page 2, box 1h, on line 21a; 21a. 21b.
multiply line 21a by $750; and enter the result on line 21b)
21. Exemptions
(If the amount on line 21b exceeds the amount of resident income on line 20c,
enter unused portion (line 21b less line 20c) on line 21c) 21c.
22a. Total income subject to tax as a resident (Subtract line 21b from line 20c; if zero or less,enter zero) 22a.
22b. Total income subject to tax as a nonresident (Subtract line 21c from line 20c; if zero or less,enter zero) 22b.
23a. Tax at nonresident rate (MULTIPLY LINE 22a BY 1.0% (0.01), THE RESIDENT TAX RATE) 23a.
23b. Tax at nonresident rate (MULTIPLY LINE 22b BY 0.5% (0.005), THE NONRESIDENT TAX RATE) 23b.
23c. Total tax (Add lines 23a and 23b) (ENTER HERE AND ON FORM SF-1040, PAGE 1, LINE 23b, 23c.
AND PLACE A MARK (x) IN BOX 23a OF FORM SF-1040)

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A             Total     GROSS RECEIPTSfrom business or profession earnedEVERYWHERE                                               A. $_________________
B             Total     GROSS RECEIPTSfrom business or profession earnedIN SPRINGFIELD                                           B. $_________________
C.            Divide Line B by Line A to figure percentage of gross receipts allocable to Springfield                            C. ________________%
D.            Multiply the percentage on Line C by the amount on Line 31 of your federal Schedule C (Net profit or loss)         D. $________________
                        Enter this amount on form SF-1040 Line 6, Column C 

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                                                                                       non-resident.

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