【Municipal and Prefectural Taxes】How to fill out a Tax Return

A	Current Address
B	Address on January 1
C	Name
D	Phone Number
E	Date of Birth
F	Individual Number (My Number)
1. Earnings
a	Sales earnings
b	Farming earnings
c	Real estate earnings
d	Interest earnings
e	Dividend earnings
f	Employment earnings
g	Public pension earnings
h	Business gross income
i	Other gross income
j	Short-term capital gains
k	Long-term capital gains
l	Occasional gross income
2. Income
1	Sales income
2	Farming income
3	Real estate income
4	Interest income
5	Dividend income
6	Employment income
7	Net income from public pensions
8	Net income from business
9	Other net income
10	Total net income (Sum of 7 through 9)
11	General transfers and occasional net income
12	Total net income (Sum of 1 through 6, 10, 11)
4. Deductions from Income
13	Social insurance premium deduction
14	Small business mutual aid premium deduction
15	Life insurance premium deduction
16	Earthquake insurance premium deduction
17 - 18	Widow (widower) /single parent deductions
19 - 20	Working student exemption / Disability exemption
21	Special spousal deductions
22	Dependent exemption
23	Special Deduction for Specified Relatives
24	Basic exemption
25	Total deductions (Sum of 13 through 24)
26	Casualty losses deduction
27	Medical expense deduction
28	Total deductions (Sum 25 through 27)
21'	Name, date of birth, income of spouse
22'-23'	Name, date of birth, living situation (living together or separately), and relation to applicant of dependents aged 16 and over If your dependent lives at a separate address from you, please indicate this in section 30.
29	Name, date of birth, living situation (living together or separately), and relation to applicant of dependents aged 16 and over If your dependent lives at a separate address from you, please indicate this in section 30.
30	Name, My Number (for those who have it), address, etc. of dependents. If your dependent lives outside of Japan If you did not provide your company with a year-end tax adjustments certificate, please submit documents ① and ② along with a tax return form. A translated copy is required for certificates in a foreign language. ① Proof of bank transfer or documents from credit card issuer (showing sender and recipient's name) ② Proof of familial relationship (marriage or birth certificate) Additional documents are required in addition to ① and ② for dependents living outside of Japan between the ages of 30 and 69. Please refer to the National Tax Agency homepage for further details.

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Hamamatsu City Office

〒430-8652 103-2 Motoshiro-cho, Chūō-ku, Hamamatsu-shi