Business Tax Return Form - City Of Blue Ash - 2011
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1
2City of Blue Ash
Business Tax Return
Income Tax Office
2011
4343 Cooper Road
Blue Ash, OH 45242
OR
Phone: (513) 745-8516
FISCAL PERIOD __________ TO __________
Fax: (513) 745-8651
_______
Amended Return - Tax Year:
Website:
April 17, 2012
Calendar Year Taxpayers file on or before
Email:
THIS SPACE IS FOR OFFICIAL USE ONLY
th
th
Fiscal Year Due on 15
Day of 4
Month After Year End
Did you file a City return last year?
Is this a combined corporate return?
Should your account be inactivated?
YES
NO
YES
NO
YES
NO
If YES, please explain:
FID# ____-______________
Phone # _________________
Filing Status (Check one)
C-Corporation
S-Corporation
LLC
Partnership/Association
If the information above is incorrect, please make corrections.
Partial Year: Start date________ End Date_________
Part A
TAX CALCULATION
Adjusted Federal Taxable Income (Attach Copy of Federal Return) From Form ________ Line ________……….
1.
$
Adjustments (From Line L, Schedule X)……………………………………………………………………………………
2.
$
Taxable income before apportionment (Line 1 plus/minus Line 2)………………………………………………………
3.
$
Apportionment percentage (From Step 5, Schedule Y) _________%…………………………………………….……
4.
Blue Ash taxable income (Multiply Line 3 by Line 4)…………………………………………………………………..…
5.
$
Net operating loss carry-forward claimed. Limited to five years (attach schedule)……………….………………….
6.
$
Amount subject to Blue Ash income tax (Line 5 plus/minus Line 6)……..………………………………………….
7.
$
8.
Blue Ash income tax (Multiply Line 7 by 1.25% [.0125])…………………………………………………………………
$
Estimates paid on this year’s liability………………………………………
9 a.
$
Credits applied to this year’s liability……………………………………….
9 b.
$
Total payments and credits (Lines 9a + 9b) ……………………………………………………………………………..
10.
$
Tax due (Subtract Line 10 from Line 8)………………………………………………………………………………….
11.
$
Overpayment (Line 10 greater than Line 8)………………………………
12.
$
………..
13.
Amount to be refunded
$
(Amounts less than $1 will not be refunded)
14.
Amount to be credited to next year………………………………………..
$
DECLARATION OF ESTIMATED TAX FOR 2012 –
Part B
Mandatory if estimated Liability is $100.00 or more
Total estimated income subject to tax……………………………………………………………………….……………
15.
$
Blue Ash income tax declared (Multiply Line 15 by 1.25% [.0125])…………………………………………………...
16.
$
Tax due before credits (at least 25% of Line 16)…………………………………………………… …………………..
17.
$
Less credits (from Line 14 above)…………………………………………………………………………….…………...
18.
$
Net estimated tax due if Line 17 minus Line 18 is greater than zero*……………………………………….………..
19.
$
20.
TOTAL AMOUNT DUE—Line 11 plus Line 19 (Make checks payable to the Blue Ash Income Tax Office)
$
FOR TAX OFFICE USE ONLY
Tax $__________ Penalty $__________ Interest $___________ Late ______ months
TOTAL DUE $__________________
*Subsequent estimated payments are due by the last day of the month following each quarter of the taxable year.
Check here if we may contact the tax preparer directly with questions regarding the preparation of this return.
The undersigned declares that this return (and accompanying schedules) is a true, correct and complete return for the taxable period stated
and that the figures used herein are the same as used for Federal Income Tax purposes.
__________________________________________________________
_______________________________________________________
Signature of Person Preparing Return
Date
Signature of Officer or Agent
Date
___________________________________________
_________________________________________
Name of Person Preparing Return
Phone Number
Name and Title
Phone Number
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