Individual Tax Return Form - City Of Monroe - 2015
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1
2City of Monroe
Individual Tax Return
Income Tax Division
2015
P. O. Box 629
Monroe, Ohio 45050
OR
Phone: (513) 539-7374
FISCAL PERIOD _______ TO _______
Fax: (513) 539-6209
Calendar Year Taxpayers file on or before April 18
Website:
THIS SPACE IS FOR OFFICIAL USE ONLY
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Fiscal Year Due on 15
Day of 4
Month After Year End
Account Number
Spouse’s Name __________________
Spouse’s SSN ______-____-_______
Name
Part-Year Resident From______ to _______
Address
Phone No.
City/State/Zip
Did You File a Return Last Year?
YES
NO
IF INFORMATION ABOVE IS INCORRECT, PLEASE MAKE CORRECTIONS
Part A
Tax Calculation
(Attach front page of Federal Form 1040)
1.
Total Qualifying Wages (Attach W-2 Forms) For multiple W-2s complete Worksheet A on page 2………………
$
Less Employee Deductions (Attach Form 2106, 2% ALLOWANCE)……..………………………………………...…
2.
$
3.
Taxable Wages Before Adjustment. (Line 1 minus Line 2)………………………………………………………………
$
4.
Less Nontaxable Income (part-year or non-residents only) (provide calculations)…………………………………….
$
5.
Taxable Qualified Wages (Line 3 minus Line 4)………………………………………………………...…………………
$
Other Income or (Loss) From Federal Schedules C, E, F, K-1, 1099-MISC (See Worksheet B Line 6)
6.
$
(Attach copies of all Federal Schedules)………………………………………………………………………………..
7.
Monroe Taxable Income (Line 5 plus Line 6) Losses on Line 6 do not offset W-2 Income from Line 5………...
$
8.
Monroe Income Tax (Multiply Line 7 by 1.5% [.0150])…………………………………………………………………...
$
9 a.
Monroe Tax Withheld (per W-2s)…………………………………………...
$
Estimates Paid (including credit from previous year)……………………..
9 b.
$
9 c.
$
Other Local Taxes Paid (Allowed up to 1.5% credit)………………..……
10.
Total Payments and Credits (Lines 9a + 9b + 9c)…….…………………………………………………………………..
$
11.
Tax Due (Subtract Line 10 from Line 8)…………………………………………………………………………………….
$
12.
Penalty $_____________ Interest $______________ …………………….Total Penalty & Interest Due…………..
$
13.
Total Amount Due (Add Line 11 and Line 12)(Amounts less than $5.00 not payable)…..…………………………...
$
14.
Overpayment – Credit to 2015 (Line 10 greater than Line 8)…………….
$
15.
Refunded (Amounts less than $5.00 will not be refunded)……………….
$
Part B
Declaration of Estimated Tax for 2016
16.
Total estimated income subject to tax………………………………………………………………………………………
$______________________
17.
Monroe Income Tax Declared (Multiply Line 16 by 1.5% [.0150])………………………………………………….……
$______________________
18.
Estimated Taxes Withheld from Wages…………………………………………………………………………………….
$______________________
Tax due after Withholding (Line 17 less Line 18) STOP if this amount is less than $0.00..…………………………..
19.
$______________________
20.
Declaration Due (25% of Line 19)…………………………………………………………………………………………...
$______________________
21.
Less credits (from Line 14 above)…………………………………………………………………………………………...
$______________________
22.
Net estimated tax due if Line 20 minus Line 21 is greater than zero*…………………………………………………...
$______________________
23.
TOTAL AMOUNT DUE—Combine Line 13 above with Line 22 (
)
$______________________
Make checks payable to the City of Monroe
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*Subsequent estimated payments are due by the 15
of June, September, and December.
PAYING TAX DUE BY CREDIT CARD
1. Circle One:
MASTERCARD
VISA
DISCOVER
2. Account Number (16 digits): ______________________ _______________________ _______________________ ______________________
3. Expiration Date: ______/______ (mm/yy)
4. Verification Code (must be provided to process):________________________________________
5. Amount to Be Paid: $_______________________ 6. Your Signature for Authorization: ______________________________________________
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