Form W-2 - Income Tax Worksheet - City Of Lorain - 2011 Page 2

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SCHEDULE C
PROFIT OR LOSS FROM BUSINESS OR PROFESSION
Attach Federal Schedules, (If taxes paid to other cities, attach other cities’ returns.)
Business Name
Business Address
$
1. Net Profit or Loss
2. Add Items not Deductible
3. Deduct Items not Taxable
(
)
$
4. Adjusted Net Profit or Loss
5. Schedule Y_______% allocable to Lorain from Schedule Y Step 5
6. Less allocable net loss carry-forward 5 year limit Attach NOL Schedule
$
7. Net Profit or Loss (NET PROFIT ONLY, enter on Line 4, page 1)
{For Corporate Entitles Only - see Schedule X at www.
SCHEDULE E - PROFIT OR LOSS FROM RENTS
Addresses of properties must be listed on Federal Schedule E and attached to this return
TOTAL PROFIT/LOSS
$
SCHEDULE H
ALL OTHER TAXABLE INCOME
Individual’s distribtive share of Income from partnerships, s-corporations, estates, trusts, director’s and other fees, farm and other sources.
Received From
For (DESCRIBE)
Amount
$
TOTAL INCOME - Enter Line 4, page 1
$_______________________
SCHEDULE Y - Business Allocation Formula
USE WHOLE DOLLARS ONLY!
A. Located Everywhere
B. Located in Lorain
% B Divided by A
STEP 1.
a) Average original cost of Real & Tangible Personal Property
b) Gross Annual Rentals Paid multiplied by 8
c) Total of Step 1
STEP 2.
Net Sales
STEP 3.
Wages, Salaries Paid
STEP 4.
Total Percentages
STEP 5.
AVERAGE PERCENT (Divide Total Percent by Number of Percentages Used) Enter Here and on Line 5 Schedule C.
EXEMPTION CERTIFICATE (Signature is required on front of this form)
I have no taxable income because of the reason indicated blow:
RETIRED - I received only pension, social security and/or interest or dividend income.
Under 18 for the entire year of __________. My date of birth is ___/___/___ (Attach proof of DOB)
ACTIVE MEMBER OF THE U.S. ARMED FORCES FOR THE ENTIRE YEAR OF __________.
(This exemption does not include civilians employed by the military or the National Guard)
NO EARNED INCOME FOR THE ENTIRE YEAR OF __________.
(Public Assistance, SSI, Unemployment, ect. is not considered earned income.)

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