Income Tax Return Form - The Village Of Deshler

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THE VILLAGE OF DESHLER
“The Corn City”
DESHLER, OHIO 43516
INCOME TAX RETURN
FOR THE CALENDAR YEAR 20_____
OR OTHER TAXABLE PERIOD BEGINNING — ___________________ 20_____ ENDING ___________________ 20_____
Your social security number
NAME _______________________________________________________
________
________
________
Spouse’s social security number
ADDRESS ____________________________________________________
________
________
________
Spouse’s name
CITY ________________________________________________________
______________________________
CHECK ANY OF THE BELOW IF THEY APPLY
L PERSONAL RETURN
L JOINT RETURN
L CORPORATION RETURN
L INDIVIDUAL PROPRIETOR RETURN
L PARTNERSHIP RETURN
L PROFESSIONAL OR BUSINESS RETURN
L OTHER (EXPLAIN) _______________________
1.
WAGES, SALARY, TIPS, ETC. SUBJECT TO DESHLER TAX
______________________________
2.
NET PROFIT FROM RENTALS
______________________
CREDIT — LOSS IN PREVIOUS YEAR
______________________
(IF LOSS ENTER 0)
______________________________
3.
NET PROFIT FROM FARMING
______________________
CREDIT — LOSS IN PREVIOUS YEAR
______________________
(IF LOSS ENTER 0)
______________________________
4.
NET PROFIT FROM BUSINESS OR PROFESSION
______________________
CREDIT — LOSS IN PREVIOUS YEAR
______________________
(IF LOSS ENTER 0)
______________________________
5.
NET PROFIT FROM PARTNERSHIPS ETC.
______________________
CREDIT — LOSS IN PREVIOUS YEAR
______________________
(IF LOSS ENTER 0)
______________________________
6.
TOTAL INCOME SUBJECT TO DESHLER INCOME TAX
LINES 1 + 2 + 3 + 4 + 5
______________________________
7.
DESHLER TAX 1/2% (.005) OF LINE 6
______________________________
8.
CREDIT — PAYMENT (S) MADE ON DECLARATION
______________________
9.
CREDIT — DESHLER TAX WITHHELD FROM WAGES (W2) ______________________
10. CREDIT — OVERPAYMENT IN PREVIOUS YEAR
______________________
TOTAL CREDITS
______________________________
11. BALANCE OF TAX DUE (MAKE CHECK PAYABLE TO VILLAGE OF DESHLER)
______________________________
12. ENTER OVERPAYMENT HERE FOR CREDIT ON NEXT YEAR’S TAX.
NO REFUND WILL BE MADE EXCEPT BY SPECIAL REQUEST
______________________________

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