Germantown Individual Income Tax Return - Ohio, Income Tax Department - 2006
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1
2PLEASE ATTACH W-2s ON BACK
INCOME TAX DEPARTMENT
FOR TAX OFFICE USE ONLY
75 N. WALNUT STREET
2 0 0 6
AMOUNT PAID WITH THIS RETURN
GERMANTOWN, OHIO 45327
G E R M A N T O W N
(937) 855-7258
CHECK
CASH
MONEY ORDER
MAKE CHECK PAYABLE TO: GERMANTOWN INCOME TAX
I N D I V I D U A L
PAY TAXES PROMPTLY TO AVOID PENALTY
CHECK NO. ________________________
INCOME TAX RETURN
DATE OF AUDIT ____________________
________________________________
TAXABLE PERIOD BEGINNING ________________ ____ AND ENDING ____________ ____
AUDITED BY ______________________
FILING REQUIRED EVEN IF NO TAX DUE
TELEPHONE:
S
HOME ________________________________________________
FILE ON OR BEFORE APRIL 16, 2007
E
BUSINESS ____________________________________________
NAME & ADDRESS: Indicate Change(s) By Checking
Name
Address Effective Date: ______________________
C
SOCIAL SECURITY NUMBER:
T
TAXPAYER ____________________________________________
I
SPOUSE ______________________________________________
O
PART YEAR RESIDENT FROM __________TO______________
N
DID YOU FILE A RETURN LAST YEAR?
YES
NO
LIST PERSONS 17 YEARS OF AGE & OLDER LIVING IN YOUR HOUSEHOLD
I
Name
Date of Birth
Social Security No.
Relationship
DO YOU OWN RENTAL PROPERTY?
YES
NO
IF RENTING A RESIDENCE, GIVE NAME AND ADDRESS OF OWNER:
S
E
THE FOLLOWING INCOME IS NOT TAXABLE:
RETIREMENT PENSIONS, UNEMPLOYMENT INSURANCE, WELFARE, DISABILITY BENEFITS, PROCEEDS OF INSURANCE, ANNUITIES OR GRATUITIES, INTEREST OR DIVIDENDS.
C
IF YOU OR YOUR SPOUSE HAVE INCOME FROM SOURCES OTHER THAN THOSE LISTED ABOVE, COMPLETE SECTIONS I, III & IV.
T.
IF YOU OR YOUR SPOUSE DO NOT HAVE INCOME FROM SOURCES OTHER THAN THOSE LISTED AS NOT TAXABLE, SIMPLY COMPLETE SECTION I THEN SIGN AND RETURN.
II
SIGN ______________________________________________________
________________________________________________________ DATE ____________________
PRIMARY FILER
SPOUSE
1.
WAGES, SALARIES, TIPS AND OTHER COMPENSATION (ATTACH ALL W-2s) .......................................................................... $ ______________
2.
1099 MISC. COMPENSATION INCOME NOT INCLUDED ON LINE 14, ENTER TOTAL .............................................................. $ ______________
3.
OTHER TAXABLE INCOME OR DEDUCTIONS (COMPLETE THE TOP HALF OF BACKSIDE OF THIS FORM) .......................... $ ______________
S
4.
TAXABLE INCOME: ADD LINES 1, 2 AND 3. ENTER TOTAL ........................................................................................................ $ ______________
E
5.
GERMANTOWN TAX: CALCULATE LINE 4 TIMES .0125 AND ENTER TOTAL ............................................................................ $ ______________
C
6.
CREDITS:
T
A. TAX WITHHELD BY EMPLOYER FOR MUNICIPALITY OF GERMANTOWN FROM W-2, ENTER TOTAL $ ______________
I
B. TOTAL PAID TOWARD ESTIMATE TAX TO GERMANTOWN, ENTER TOTAL .......................................... $ ______________
O
C. ENTER TOTAL FROM LINE 4 OF THE INCOME TAX WORKSHEET ........................................................ $ ______________
N
D. PRIOR YEAR OVERPAYMENTS, ENTER TOTAL ...................................................................................... $ ______________
III
E. TOTAL CREDITS: ADD LINES 6A, 6B, 6C, AND 6D — ENTER TOTAL .................................................................................... $ ______________
TAX DUE
7.
SUBTRACT LINE 6E FROM LINE 5 — ENTER TOTAL ............................................................................................
$
A. $25.00 LATE FEE WILL BE ASSESSED ON ALL RETURNS RECEIVED AFTER APRIL 17 ............ $ ________________
B. TOTAL AMOUNT DUE ...................................................................................................................... $ ________________
8.
OVERPAYMENT IS $ __________ CHECK THE APPROPRIATE BOX: REFUND
OR CREDITED TO NEXT YEAR’S ESTIMATE
MANDATORY DECLARATION OF ESTIMATED TAX FOR YEAR 2007
S
E
9.
TOTAL INCOME SUBJECT TO TAX $ ___________ MULTIPLY BY TAX RATE OF .0125 FOR GROSS TAX OF .......................... $ ______________
C
10.
LESS EXPECTED TAX CREDITS:
T
A. WITHHELD BY EMPLOYER FOR GERMANTOWN .............................................................................. $ ________________
B. PAYMENTS ON TAXABLE INCOME TO ANOTHER CITY ...................................................................... $ ________________
I
C. TOTAL CREDITS ........................................................................................................................................................................ $ ______________
O
11.
NET TAX DUE (LINE 9 LESS LINE 10C) ........................................................................................................................................ $ ______________
N
A. MINUS OVERPAYMENT FROM PRIOR YEAR (S) ................................................................................ $ ________________
IV
B. BALANCE OF ESTIMATED TAX DUE ........................................................................................................................................ $ ______________
12.
AMOUNT PAID WITH THIS DECLARATION (.25 OF LINE 11 MINUS 11A) .................................................................................. $
TOTAL
13.
AMOUNT ENCLOSED .............................. (LINE 7) $ ____________ ........................ (LINE 12) $ __________
$
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 OF PERSON PREPARING IF OTHER THAN TAXPAYER
DATE
SIGNATURE OF TAXPAYER OR AGENT
DATE
ADDRESS AND TELEPHONE NUMBER
WHITE COPY TAX OFFICE
YELLOW COPY TAXPAYER’S
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