Form L-1 - City Income Tax Return For Individuals (2005)
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2CITY OF LAKEWOOD – DIVISION OF MUNICIPAL INCOME TAX
L-1
2005
City Income Tax Return For Individuals
Due By: April 15, 2006
Name(s) and Current Address
Taxpayer’s Social Security Number
Make checks payable and mail to:
City of Lakewood – Division of Municipal Income Tax
12805 Detroit Avenue Lakewood, OH 44107
Spouse’s Social Security Number (if joint)
Phone: (216) 529-6620 Fax: (216) 529-6099
Website:
If you have moved during 2005, indicate the
month and day of your move:
Filing Status – CHECK ONLY ONE
Into Lakewood - _____ / _____ / _____
Single
Previous Address ___________________________
Married - Filing Joint
Out of Lakewood - _____ / _____ / _____
Telephone (_________) ______________________________________
Present Address ____________________________
REFUND
EXTENSION attached
AMENDED Year _______________
If renting, name landlord _____________________________________________________
TABLE A: WAGES AND COMPENSATION
(ATTACH FEDERAL FORMS W-2, 1099-MISC, AND A COPY OF PAGE 1 OF YOUR 2005 FEDERAL RETURN)
LOCATION WHERE EARNED
Column 1
Column 2
List separately income earned in Lakewood
Total Wages
Withheld for
and other localities
or Compensation
Lakewood
Column 3
Column 4
Column 5
Column 6
LAKEWOOD
Withheld for
Tax Credit Limit
Smaller of
Tax Credit
other localities
(Column 1 x .01)
Column 3 or 4
(Column 5 x .50)
Federal Form 2106 expenses (From Table A-1, Line 1) (
)
OTHER LOCALITIES
Federal Form 2106 expenses (From Table A-1, Line 2) (
)
(
) (
) (
)
Part-Year Resident Deduction (From Table A-2)
(
)
(
) (
) (
) (
)
Total
Total
(to Line 1)
(to Line 6)
(to Line 7)
If you want Lakewood to calculate your tax - STOP, check the box, sign and date the return. Submit with W-2s before March 15, 2006.
INCOME
1. Wages and compensation (from Table A, Column 1)
1.
2. Other non-wage income earned in Lakewood (from Table B, Column 1, Line 6)
2.
3. Other non-wage income earned outside Lakewood (from Table B, Column 2, Line 7)
3.
4. Total taxable income (add Lines 1, 2, and 3)
4.
TAX AND CREDITS
5. Total Lakewood tax due before credits (multiply Line 4 by 1.5% or .015)
5.
6. Taxes withheld and paid to Lakewood (from Table A, Column 2)
6.
7. Wage income tax credit (from Table A, Column 6)
7.
8. Non-wage income tax credit (from Table B, Column 2, Line 11)
8.
9. Total credits (add Lines 6, 7, and 8)
9.
10. Tax due before estimate payments (subtract Line 9 from Line 5)
10.
11. 2005 estimated tax payments and unused prior year credits
11.
12. Total net tax - Subtract Line 11 from Line 10 and proceed to Line 15 If less than $1.00, enter zero and proceed to Line 13
12.
OVERPAYMENT
13. Overpayment - If Line 11 is greater than Line 10, and not less than $1.00, subtract Line 10 from Line 11
13.
14. From Line 13 - Amount to be credited to 2006 - $___________
Amount to be refunded - $___________ (Proceed to Line 16)
BALANCE DUE
15. Balance due – If Line 10 is greater than Line 11, and not less than $1.00, subtract Line 11 from Line 10
15.
ESTIMATED INCOME TAX FOR 2006
16. Estimated income tax for 2006 (from Line 10)
16.
17. First quarter payment (multiply Line 16 by 25% or .25)
17.
18. 2005 credit applied to first quarter estimate (from Line 14)
18.
19. Total amount due by April 15, 2006 (add Line 15, 17 and subtract Line 18)
19.
The undersigned declares this to be a true, correct, and compete return of Lakewood Income Tax for the period stated.
Pay by Credit Card-Mastercard / Visa
Taxpayer's Signature
Date
Account Number ________________________________
Spouse's Signature
Date
Exp. Date ____________ Amount Paid $ ____________
Tax Preparer's Signature (If other than taxpayer)
Phone #
Date
________________________________________________
Signature
I authorize the City of Lakewood - Division of Municipal Income Tax to discuss my account and enclosures with my preparer (above)
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