Income Tax Return Form - Village Of Loudonville - 2014
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4S.S.N./F.I.D.#
ACCOUNT #
14
AUDITED BY:
THE INCOME TAX OFFICE IS LOCATED AT 156 N. WATER ST., LOUDONVILLE
CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE APRIL 15, 2015
PHONE 419-994-3214 FOR ASSISTANCE
FISCAL AND PARTIAL YEARS, FILE WITHIN 4 MONTHS FROM END OF PERIOD
MAIL RETURNS TO P.O. BOX 150, LOUDONVILLE, OH 44842
THIS RETURN IS FOR BOTH INDIVIDUALS AND BUSINESSES
IF THE ADDRESS CAPTION IS NOT CORRECT, PLEASE MAKE NECESSARY CHANGES
FISCALS: TAXABLE PERIOD FROM__________________________ TO__________________________
TAX OFFICE USE ONLY
PAID WITH THIS RETURN
2014 FINAL RETURN $ __________________
2015 DECLARATION $ __________________
DATE RECEIVED
TOTAL REMITTANCE $ __________________
CASH
CHECK
MONEY ORDER
PARTIAL PMT.
NO PMT.
1. WAGES, SALARIES, TIPS & OTHER COMPENSATION (Enclose W-2 Forms) .................................................................................................... $ _________________
2. A.
BUSINESS PROFIT (Attach Federal Forms) PAGE 2 SECTION A....................................................................$ _________________
B.
RENTAL INCOME (Attach Federal Forms) PAGE 2 SECTION B .......................................................................$ _________________
C.
TOTAL OTHER TAXABLE INCOME(Line A Plus Line B) Not less than zero........................................................................................... $ _________________
D. ADJUSTMENTS: PARTIAL YEAR LIABILITY......................................................................................................................................................... $ _________________
3. DEDUCT EMPLOYEE BUSINESS EXPENSE (Attach Fed. 2106 Form) PAGE 2 SECTION C ........................................................................ $ _________________
4. TAXABLE INCOME (Line 1 Plus Line 2C Less Line 3) .............................................................................................................................................. $ _________________
5. VILLAGE INCOME TAX DUE 1.75% OF LINE 4............................................................................................................................................................ $ _________________
6. CREDITS
A.
LOUDONVILLE INCOME TAX WITHHELD (Attach W-2’s) .............................................................................. $ _________________
(Attach W-2’s).... $ _________________
B.
INCOME TAX PAID OTHER MUNICIPALITIES
(Not to Exceed 1.75% Each W-2 Separately)
C.
OVERPAYMENT FROM PRIOR YEAR...................................................................................................................... $ _________________
D. ESTIMATED TAX PAYMENTS.................................................................................................................................... $ _________________
E.
TOTAL CREDITS (Add Lines A, B, C, D) ............................................................................................................................................................... $ _________________
7. BALANCE TAX DUE, IF LINE 5 IS GREATER THAN LINE 6E (Payment in full must accompany return) .................................................... $ _________________
8. PENALTY $______________________________ INTEREST $___________________ PAGE 2 SECTION D ........................................ $ _________________
9. AMOUNT DUE PAYABLE TO VILLAGE OF LOUDONVILLE (LINE 7 PLUS 8) ...................................................................................................... $ _________________
10.OVERPAYMENT TO BE REFUNDED $_______________ OR CREDITED $____________ TO NEXT YEAR ESTIMATE.
NOTE: No refund will be made until next Declaration is
No taxes or refunds o ess than $2.00 shall be collected or refunded.
Refunds cannot be made of taxes paid to other cities or villages.
DECLARATION OF ESTIMATED TAX FOR YEAR 2015
11. Total income subject to Loudonville tax $___________________ 12. Loudonville tax @ 1.75% ........................................................$ __________________________
13. LESS TAX TO BE WITHHELD
a. By Loudonville Employer .................................................................................................................................................$ _____________
b. By an employer in _____________________________ (name of city) ............................................................$ _____________
14. Balance estimated Loudonville tax (Line 12 less total of line 13) .................................................................................................................$ __________________________
15. Less Credits: a. Overpayment on previous year’s return...................................................................... $ . ____________
b. Previous payments if this is an amended declaration........................................... $ . ____________
c. Other (Specify) .................................................................................................................... $ . ____________ Total Credits $ __________________________
16. Next tax due (line 14 less total of line 15) ..............................................................................................................................................................$ __________________________
17. Amount paid with this return (not less than 22.5% of line 16)........................................................................................................................$ __________________________
18. Balance of Tax.................................................................................................................................................... $.________________________
19.Total Amount Due (Line 9 plus 17) ............................................................................................................................................................................... $ __________________________
MAKE REMITTANCE PAYABLE TO: VILLAGE OF LOUDONVILLE TAX DEPARTMENT
I CERTIFY THAT I HAVE EXAMINED THIS RETURN (INCLUDING, ACCOMPANYING SCHEDULES AND STATEMENTS) AND TO THE BEST OF MY
KNOWLEDGE AND BELIEF IT IS TRUE CORRECT AND COMPLETE. IF PREPARED BY A PERSON OTHER THAN TAXPAYER. THE DECLARATION
IS BASED ON ALL INFORMATION OF WHICH PREPARER HAS ANY KNOWLEDGE.
_________________________________________________________
__________________________________________________________
Signature
Date
Signature
Date
_________________________________________________________
Phone
I (We) authorize the Income Tax Department to discuss my return and enclosures with the preparer above. Initial here____________
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