TREASRY DEPARTMENT INDIVIDUAL INCOME TAX RETURN
INTMBNAT. RivNNUs SBEBV.C3
FOR NET INCOMES OF NOT MORE THAN $5,000
DERIVED CHIEFLY FROM SALARIES AND WAGES
For Calendar Year 1935
THIS COPY To be filed with the Collector of Internal Revenue for your district on or before March 15, 1936 If you need assistance
TO -BE PRINT NAME AND ADDRESS PLAINLY BELOW in preparing hi
RETAINED IE---deputy collector or
band~~~~ BY orwf uigyu (Name) (Both husband and wife, if this is a joint return) to the collector's
TAXPAYER |-------
---/e--a
-
-----------------------------office.
TAXP VA YER^ 1 (Street and number, or rural route)
ia 1-WeIa-----TA L------l----A
t--a -^
(Post office) ( t) ((Cunt State)
_________ ^___~6E. _OCUATION -
---
-------------------------------------------------------------OCCUPATION
8 e
1. Are you a citizen or resident 3. Was a separate return filed by 5. How many dependents (except husband or wife) received
of the United States?. ..il husband or wife?---
their chief support from you during your taxable year?_i
2. Were you married and living with hus
. 4. If not married, were you the head of a 6. State date and nature of any change
band or wife during your taxable year?.
J family during your taxable year? ...-
under questions 2, 4, or 6 during the year
.
Im* INCOME . . . ..;
_ X
-_ _
1. Salaries, wages, commissions, fees, etc. (State from whom received) ------------------
-
-------------.
--
----------------------------..--
-Ir a^
2. Interest on bank deposits, notes, mortgages, and corporation bonds -----------3.
Interest on bonds upon which a tax of 2% was paid at source-------------4.
Other income (including income from fiduciaries, partnerships, etc.) (State source):
-...... .. ... t-------------------------------------
-------5.
TOTAL INCOME IN ITEMS 1 TO 4 -. -------
---------------
$-----4y 01I
DEDUCTIONS ~ /
6. Taxes paid ... .n.-----
-------------(State
and amounts) . _ .
7. Contributions --i-a. .3 lt --t-o-4--. (Furnish
names of organizations and.sw ts contributed to each)
8. Other deductions authorized by law. (Furnish details)__'
..-.... .. rl. -
-.
TOTAL DEUCTIONS IN ITEMS 6 TO 8 ---
-------------------
-----COMPUTATION
OF TAX
10. Net income for normal tax purposes (item 5 minus item 9) -----------------------------------------------------------
$----11.
Less: Earned income credit-| $-.-..-.>5S
.3.
12. Personal exemption------------------------------
---
.
dA)
---------^^de----
----
l
14. Balance taxable at 4% (item 10 minus items 11, 12, and 13) ---------------------------------------------------
$-----15.
Total income tax (4% of item 14) --------------------------------------------------------------------------------------------
$-----t
16. Less: Income tax paid at source on tax-free covenant bonds (2% of item 3)---------------
$-----------------17.
Income tax paid to a foreign country or United States possession. (Attach Form 1116) ... --
-
--. 18.
BALANCE OP TAX (item 15 minus items 16 and 17) $
.----2-16940
Boyce Ditto
20 february
Notary Publie BOYCE DITTO PUBLIC LIBRARY
