Village Of Brewster Income Tax Return Form
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Village of Brewster, Ohio
Small Town America
Village Income Tax Form
Village of Brewster Income Tax Return
For the Calendar Year of 20__, Filing Deadline April 30, 20__
Name
SSN
Address
Spouse
SSN
Did you reside in Brewster all year?
Yes ____
No _____
If not, Move in date
/
/
, Move out date
/
/
W-2 Income : List Gross Income by employer, attach all W-2’s
AMOUNT
_______________________________________________
$ _________
_______________________________________________
$ _________
_______________________________________________
$ _________
_______________________________________________
$ _________
_______________________________________________
$ _________
Total
(A) $ _________
Business, Professional and Rental Income : attach Federal Schedule C or E
_______________________________________________
$ _________
_______________________________________________
$ _________
_______________________________________________
$ _________
Total
(B) $ _________
C. Total Gross Income (A plus B)
( C) $ _________
D. Total Brewster Income Tax Due (C times .0133)
(D) $ _________
E. Brewster Income Tax Withheld
(E) $ _________
F. Credit for Taxes Paid NOT TO EXCEED 1.33% PER W-2
(F) $ _________
G. Total Credits (E plus F)
(G) $ _________
H. Tax Owed (D minus G)
(H) $ _________
I. Amount Paid with Return
(I) $ _________
J. Interest (@ 2% per month for failure to timely pay, $25 min)
(J) $ _________
Balanced Owed
$ ____________
I hereby certify the above is true, correct and complete pursuant to the Brewster Ordinances and
regulations.
Signed_____________________________________________ Date ________________
Signed_____________________________________________ Date ________________
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Parent category: Financial