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(FORM 47, PAGE 2.)

DEPUTY COLLECTOR'S AFFIDAVIT. I, , Deputy Collector, Division, District, being duly sworn according to law, depose and say that I have personally investigated the statements made in the within affidavit, * and from the best information I can obtain, after careful inquiry, I believe such statements to be in all respects just and true.

[Signature] Sworn to and subscribed before me this day of A. D. 189.

[Signature]

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CERTIFICATE OF ASSESSMENTS.T. I hereby certify that, upon careful examination, I find that the within-named assessments appear upon the lists in my office as follows:

Name.

Article or
Occupation.

Period co

vered by assessment.

List.

Page.

Line.

Column.

Amount.

[Signature] 189.

Collector, District of * See Series 7, No. 14, page 10, for instructions in filling this blank.

† Not only the record of the assessment claimed as abatable, but the record of all assessments mentioned in the affidavit, should appear in this blank. The full amount assessed should be entered in every case, even where only a part of the assessment is claimed as abatable. Assessments in column 10 should be scheduled on Form 489, and assessments in column 104 should be scheduled on Form 333.

(FORM 129, REVISED MARCH, 1882.)

COLLECTOR'S SUMMONS TO TESTIFY.

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UNITED STATES OF AMERICA,
OFFICE OF THE COLLECTOR OF INTERNAL REVENUE,

DISTRICT OF By virtue of the authority vested in me by Section 3173 of the Revised Statutes of the United States, as amended, and also by Section 3163 of the same, as amended, and by Section 1 of the act entitled “ An act making appropriations for the legislative, executive, and judicial expenses of the government for the year ending June 30, 1877,” etc., approved August 15, 1876, you are hereby summoned and required to appear before me, Collector of the United States Internal Revenue, duly appointed, commissioned, and qualified as such, for the District of

at my office, No. Street,

189 at o'clock M. of that day, then and there to testify before me in a certain arising under the internal revenue laws, depending before me, wherein

Failure to comply with this summons will render you liable to attachment as for contempt, and punishment by the court, as provided by Section 3175, Revised Statutes of the United States. Given under my hand and seal, at my office aforesaid, on this day of 189.

[Signature]
Collector Internal Revenue,

District of
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(FORM No. 365, PAGE 1.)

INCOME TAX OF PERSONS,

1894.

INSTRUCTIONS RELATIVE TO ANNUAL RETURNS.

1. All persons who are required by law to make and render a personal list or return of the amount of their income, gains, and profits received in the preceding calendar year, and all persons who are required to make and render a list or return of the amount of income, gains, and profits of any minor or person for whom they act, shall, on or before the first Monday of March in each year, make out such list or return in the form and manner indicated on pages 2 and of this blank.

2. The person making the return shall subscribe his name thereto in full, and shall state his place of residence and occupation, and if he is not a citizen of the United States he shall so state.

3. In case such list or return is made for or in behalf of any minor or other person, or estate, the fact shall be stated. The right and authority of any person who makes and renders such list or return, on the part and in the beholt of another, shall be disclosed, and the fact shown to the collector that such person was vented with such right and authority, and that it was his duty to make and render such list or return.

4. The gross amount of income derived from any particular source should be given, and entered in the return opposite the name of the source or object included in the statement. The exemption and the deductions allowed by law should be given next in order, and the several amounts should be entered opposite the several items of deductions appearing in the return.

5. The income, gains, and profits received during the year from any source pot enumerated on the blank shall be given, and the particular source from which such income, gains, and profits were received shall be enumerated on said return under paragraph 15, and the amount of income, gains, and profits derived therefrom shall be entered opposite thereto.

6. The person making the return is required to verify the same, by oath or affirmation, as indicated on the within form, by affidavit to be sworn to before some officer using a seal and authorized to administer oaths, or before a collector or deputy collector of the district.

7. The income tax must be paid in the district in which the taxpayer's return is made, to a collector or deputy collector of internal revenue.

8. Persons having an annual income of less than three thousand five hundred dollars are not required to make and render an annual return, but in all cases where the annual income of any person exceeds the sum of three thousand five hundred dollars, whether it reaches the taxable limit of four thousand dollars or not, the list or return on Form 365 should be made by such person, duly verified, and forwarded to the collector of the district in which he resides.

9. Expenses for medical attendance, store accounts, family supplies, wages of domestic servants, cost of board, room or house rent for family or personal use, are not expenses that can be deducted froin the gross profits or income in making annual returns. It was manifestly the legislative intention that the tour thousand dollars exempt from the payment of the income tax should be applied to the above enumerated expenses, and all personal expenses for the maintenance of the family and household of the taxpayer receiving the benefit of the exemption.

10. The national, state, county, school, and municipal taxes deductible from incomes comprise such internal revenue taxes as have not been included in the expenses of the business, and all such state, county, school, and municipal taxes as are assessed ratably upon all persons liable to such assessment; but assessments made upon the real estate of a particular locality on account of street improvemente, sewerage, street grade or other improvements intended to benefit the particular property included in said locality, are not considered as taxes which may be deducted from incomes.

11. The interest on all bouds of the United States shall be returned as income by the person, corporation, company, or association owning or holding such bonds, except the interest on bonds of the funded loan of 11, continued at two per cent; and the bonds of the four per cent funded loan of 1907; and the bonds of the five per cent funded loans of 1904, all of which are by the law of their issuance exempt, both as to principal and interest, from all federal taxation.

12. In estimating the amount of taxable income, only such losses as shall have been actually suffered, and the annount of which has been definitely ascertained during the year covered by the return, can be deducted from the gross profits for that year. No deduction will be allowed for any losses not specifically described and set forth in the annual return of the person or corporation claiming the deduction.

13. Non-residents are not entitled to the exemption of four thousand dollars, or to any exemption whaterer, unless they make out their annual returns, duly verified hy oath or affirmation, and deliver the same to the deputy or collector of the district wherein their property or business from which income is derived is situated, in the time prescribed in the case of residents. In preparing returns, non-residents may, when necessary, use two forms, No. 345 - one for income from all sources, and one for income derived from business or any other source in the United Stutes.

14. Persons receiving fees or emoluments for professional or other services, as in the case of physicians or lawyers, should include all actual receipts for services rendered in the year for which return is made, together with all unpaid accounts, charges for services, or other income due for that year, if good and collectible.

15. The annual return of merchants and manufacturers of their gains, profits, or income should cover the business of the year, from the first day of January to the 31st day of December in the year for which return is made ; and their books of account, stock records, and inventories should be kept and taken at such time and in such manner as to clearly show the gross profits, business expenses, net profits or income for the year ending at the close of business hours on the 31st day of December

16. The interest accrued during the year on notes, bonds, or other evidences of indebtedness, if good and collectible at the end of the year, should be returned as income, whether actually collected or not. Dividends payable in 1874 should be returned as income for that year, no matter when declared,

17. Dents which were contracted during the year 1994, but found in snid year to be absolutely worthless, may be delucted from the income of the creditor in his annual return for said year, but such debts cannot be considered or returned as worthless until after legal proceedings to recover the same have proved fruitless, or it clearly appears that the debtor is insolvent, and that proceedings to collect the debt would avail nothing. In making the deduction for worthless debts, the person claiming the same must state in his return that one of the facts as above set forth exists in connection with the debt returned as Worthless.

18. Where the salary or compensation paid to any person in the service of the United States does not exceed the rate of $4,000 per annum, or will not rench that sum in the calendar year, or is paid in fees, or is uncertain or irregular in amount or in the time during which the same was earned or has accrued, such salary or compensation shall be included in estimating the annual gains or income of the person to whom the same was paid, and shall be entered on his annual return (Form No. 385) to the collector with his other sources of income. All salaries or compensation paid to officers or persons in the employ of the government of the United States in and for the calendar year 1894 shall be included in the annual returns to collectors, on Form 365. of such officers and persons, in statements of gains, profits, and incomes sub ject to income tax for that year.

(FORM No. 365, PAGE 2.) RETURN OF GAINS, PROFITS, AND INCOME RECEIVED BY CITIZENS OF THE

OTHER PERSONS RESIDING THEREIN, HAVING AN INCOME OF MORE THAN BY PERSONS RESIDING WITHOUT THE UNITED STATES OWNING PROPERTY ON IN THE UNITED STATES DURING SAID YEAR; AND BY GUARDIANS AND PERSONS

CORPORATIONS ACTING IN ANY FIDUCIARY CAPACITY. Return to be made to the collector or a deputy collector of the district on or before the

or before the first day of July, 1895. — Sec

OR

Annual Return of Gains, Profits, and Income received by or accrued to , of the County of

and District of the State of , from the first day of January, 1894, to the thirty-first day of December, 1894, both days inclusive, pursuant to the provisions of the Internal Revenue Laws :

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1. Gross receipts, credits, earnings, and gains from any business, or any interest

therein, wherever carried on 2. From rents received or accrued during the year 3. From protits realized on sules of real estate purchased since December 31, 1892 4. From iarming operations : Proceeds from sales of live stock

Proceeds from sules of agricultural products 5. Money, and the value of all personal property acquired by gift or inheritance 2. Income from profession, trade, or other employment, except stated salary of pay 8. From salary, compensation, or pay for particular services, and not including

salary, or compensatiou received from the United States. 9. From salary, or compensation, received for services in the civil, military, naval, or

other service of the United States, including salary of Senator, Representative,

or Delegate in Congress 10. From quins and protits, divided or undivided, of any partnership : * 11. From interest received or accrued within the year upon all notes, bonds, mort

gages, or other forms of indebtedness bearing interest, whether paid or not, if

good and collectible. 12. From interest or coupons paid or accrued on any bonds, or other evidences of in

debtedness, of any corporation, company, or association 13. From dividends or interest paid or accrued on the stock, capital, or deposits of any 14. Income of wife or ininor children computed on the same basis as this return: 15. From all sources not above enumerated, viz. :.

TOTAL GAINS, PROFITS, AND INCOME

DEDUCTIONS.

DOLLARS.

CTS.

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1. Exempt by law
2. Interest which has become due or which has been paid during

the year 3. National state, county, school, or municipal taxes paid within

the year, not including taxes assessed against local benefits 4. Amount expended in the purchase or production of live stock,

or produce sold within the vear. 5. Necessary expenses actually incurred in carrying on any busi

ness, occupation, or profession, and not elsewhere deducted

in this return 6. Losses actually sustained during the year, incurred in trade of

arising from fires, storms, or shipwreck, and not compensated for by insurance or otherwise, and not already deducted in

ascertaining profits 7. Actual losses on sales of real estate purchased since December

SI, 1892. 8. Debts a certained within the year to be worthless, and not eise

where deducted in this return. 9. Comt price of material purchased for manufacture or resale, not

increasing stock on hand December 31, 18%. 10. Dividends," lieretofore included in the statement of profits,

under para graph 13, received from corporations, companies,
or associations, on which the tax of two per centum hos once
been paid by such corporation.

TOTAL DEDUCTIONS
Taxable income for the year 1894 .

Amount of tax at two per cent

• See Instructions Nos. 11 and 16.

(FORM No. 365, PAGE 3.) UNITED STATES, WHETHER RESIDING AT HOME OR ABROAD, AND BY THREE THOUSAND FIVE HUNDRED DOLLARS FOR THE YEAR 1894; AND THEREIN, OR ENGAGED IN ANY BUSINESS, TRADE, OR PROFESSION CARRIED TRUSTEES, EXECUTORS, ADMINISTRATORS, AGENTS, RECEIVERS, AND ALL SECTIONS 27, 29, AND 31, ACT OF August 28, 1894. first Monday of March, 1895, and the tax to be paid to the collector or deputy on tions 29, 30, and 34, act of August 28, 1894.

The person making the foregoing return is required to answer the following questions, namely:

Question 1. Had your wife, or any minor child or children of yours, any income last year ?

Answer 1.
Question 2. Have you included such income or incomes in this return ?
Answer 2.
Question 3. Have you kept books of account?
Answer 3.
Question 4. Is your income herein estimated, or taken from your books?
Answer 4.

Question 5. What are the particular items of Losses set forth by you opposite paragraph 6 of “ Deductions,” and when did each occur ?

Answer 5.

66

Question 6. Are you a citizen of the United States, and what is your occupation ?

Answer 6.

Question 7.* How did you determine that debts returned by you as worthless " could not be collected ?

Answer 7.

Question 8. What were the “ necessary expenses," and the amount of each class, included in the amount set opposite paragraph 5 of “ Deductions” ?

Answer 8.

}

STATE OF
COUNTY OF..

ss.:

being duly sworn, on his oath (or affirmation) deposes and says that the foregoing return contains a full, true, particular, and correct account of all gains, profits, or income received by or accrued to ...... from the first day of January, 1894, to the thirty-first day of December, 1894, both days inclusive; and that said return contains a true account of all his income from every source. whether derived from any kind of property, rents, interest, dividends, undivided profits, wages, or salary, or from any trade, profession, employment, or vocation, or from any other source whatever, during said year; and that he has not received, from any or all sources of income together, any other sum for the said year besides what is herein set forth in detail; and that each item stated under the head of " Deductions” is correct, and he is honestly and truly entitled to make all the deductions from his income for said year as specifically stated in detail, and that the written answers to the above questions are true.

Sworn to and subscribed before me this . day of .....

1895.

• See Instruction No. 17.

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