Form I-6 - Individual Declaration Of Exemption
ADVERTISEMENT
1FORM I-6
1999
INDIVIDUAL DECLARATION OF EXEMPTION
CITY OF CLEVELAND HEIGHTS
P.O. BOX 18850
CLEVELAND HEIGHTS, OH 44118-0850
(216) 291-3978
Please complete this form if you feel that you should be exempt from filing a Cleveland Heights Income Tax Return for
the 1999 tax year. Your situation must satisfy one of the reasons listed below. The completion of this form is
required to avoid delinquent non-filer status.
_________________________________________________________________________________________
Your Social Security Number
Spouse’s Social Security Number
_________________________________________________________________________________________
Your First Name
Initial
Last Name
_________________________________________________________________________________________
Spouse’s First Name
Initial
Last Name
_________________________________________________________________________________________
Present Address
_________________________________________________________________________________________
City
State
Zip Code
I AM NOT REQUIRED TO FILE A 1999 FINAL RETURN BECAUSE:
[ ]
I moved from Cleveland Heights prior to 1999.
Date of Move________________________
[ ]
I was under 18 years of age for the entire year of 1999
A copy of a birth certificate must be attached.
Date of Birth________________________
[ ]
I am retired and, I had no wage or business income for the entire tax year
of 1999, (includes individuals receiving Social Security, Disability Benefits,
Interest or Dividend Income, Unemployment Benefits, or Pension as their ONLY source of income.)
[ ]
I was a member of the Armed Forces of the United States for the entire year
(this does not include civilians employed by the Military or National Guard.)
[ ]
I had no wage or business income nor did I own rental property during 1999.
UNDER PENALTY OF PERJURY, I DECLARE THE INFORMATION SUPPLIED ABOVE TO BE TRUE, CORRECT
AND COMPLETE.
_________________________________________________________________________________________
Your Signature
Date
_________________________________________________________________________________________
Spouse’s Signature
Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial