Individual Income Tax Return - City Of Parma Heights - 2010

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OFFICE
2010
CITY OF PARMA HEIGHTS
USE
ONLY
INDIVIDUAL INCOME TAX RETURN
6281 Pearl Road, Parma Heights, Ohio 44130-3084
DUE APRIL 15, 2011
PHONE (440) 888-6440 FAX (440) 885-8228
FILE #
Returns must be delivered in person or postmarked by due date
Your Social Security No.
Spouse’s Social Security No.
Spouse’s Name
Minimum Penalty of $25.00 if Filed Late
EXTENSIONS – Due on or before Filing Date
Read Extension Instructions to Avoid Penalties
Make Checks Payable to City of Parma Heights
If Retired, give date
IF YOU MOVED, COMPLETE THIS BLOCK
Date moved into Parma Heights
Previous Address
Date moved out of Parma Heights
Present Address
Other Status Change & Date
Phone No.
Daytime No.
Your Name and Address as they appear on our records. Make any Necessary Corrections
IF YOU ARE RETIRED OR DISABLED
Did NOT work last year - received no W2
Did NOT have gambling or lottery winnings
Did NOT receive Shareholder/Partnership distribution (Fed K1 from S Corp. or Partnership
Did NOT own Rental Property
#1 - Sign and Date the bottom of this form and return it on or before April 15, 2011
#2 - If you filed a Federal Form 1040 - Attach a copy of page 1
Otherwise: You must file a complete City of Parma Heights tax return - copies available at City Hall or
on our Website:
Our tax office staff is available to assist you in completing your city tax return or answer questions
everyday:
Monday - Thursday - 9:00 A.M. to 4:00 P.M.
Friday - 9:00 A.M. to 3:30 P.M.
I certify that this return including present address, schedules and statements are to the best of my knowledge and belief true, correct and complete.
Signature of Person Preparing, if Other than Taxpayer
Date
Signature of Taxpayer or Agent (Required)
Date
Address or Name and Address of Firm Or Employer - Phone No. (
)
Signature of Spouse, if joint return
Date

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