 |
| Your income |
| Your total gross income from
your paycheck |
|
| Other income |
| Any other income that you
receive including bonuses, alimony, child support or income
from a business |
|
| Federal tax withholding |
| Total amount withheld for
federal taxes. Enter this amount from your paystub. |
|
| State tax withholding |
| Total amount withheld for
state taxes. Enter this amount from your paystub. |
|
| Local tax withholding |
| Total amount withheld for
local taxes. Enter this amount from your paystub. |
|
| Other taxes and withholdings |
| Total amount withheld for
any other taxes or miscellaneous item. Enter this amount
from your paystub. |
|
| FICA |
| Total withheld for FICA based
on the gross income on you paycheck |
|
| Medicare |
| Total withheld for Medicare
based on the gross income on you paycheck |
|
| Insurance and benefits |
| Total amount withheld for
insurance and benefits by your employer. Enter this amount
from you paystub. |
|
| Company savings plan |
| Total amount withheld from
your paycheck that is deposited into a company savings
plan such as a 401(k) or 403(b) |
|
Equal
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