City of Cincinnati
Individual Tax Return
Income Tax Division
2011
805 Central Avenue, Suite 600
Cincinnati OH 45202-5799
Click on the fields below and type in your
OR
Phone: (513) 352-2546
information. Then print the form and mail it to
FISCAL PERIOD _________ TO _________
our office.
Fax: (513) 352-2542
Calendar Year Taxpayers file on or before April 17, 2012
Website:
th
th
Fiscal Year Due on 15
Day of 4
Month After Year End
Social Security Number: ________________
Please check all that apply:
Account Number: __________________
Spouse’s SSN:________________________
First year filer_________________
W-2 Income Only______________
Name(s)
Email:
Used Federal Schedule C, E, or F__
Partnership or LLC Income______
Address
Athlete or Entertainer___________
City/State/Zip
Account Should be Closed
.
If part-year resident indicate dates of Cincinnati residency:. From_____________To_______________
Reason: _________________________
Part A
Tax Calculation
$
1.
Total Qualifying Wages (Enclose W-2 Forms) For multiple W-2s complete Worksheet A on page 2……………
$
2.
Less Employee Deductions (Enclose Form 2106)……………………………………………………………………
$
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 less Carryforward Loss claimed
$
6.
(Complete Worksheet B on page 2 and enclose copies of all Federal Schedules)………………………………
$
7.
Cincinnati Taxable Income (Line 5 plus Line 6) Losses on Line 6 do not offset W-2 Income from Line 5……..
$
8.
Cincinnati Income Tax (Multiply Line 7 by 2.1% [.021])…………………………………………………………………...
$
9 a.
Cincinnati Tax Withheld (per W-2s)……………………………………….
$
9 b.
Estimates Paid (including credit from a previous year)…………………..
$
9 c.
Other Local Taxes Paid (Submit W-2s or Other City returns)…………
$
10.
Total Payments and Credits (Lines 9a + 9b + 9c)…….…………………………………………………………………..
$
11.
Tax Due (Subtract Line 10 from Line 8)…………………………………………………………………………………….
$
12.
Overpayment (Line 10 greater than Line 8)………………………………
$
13.
Amount to be Refunded
(Amounts less than $5.00 will not be refunded)…
$
14.
Credit to Next Year…………………………………………………………..
Part B
Declaration of Estimated Tax for 2012
$
15.
Total estimated income subject to tax………………………………………………………………………………………
$
16.
Cincinnati Income Tax Declared (Multiply Line 15 by 2.1% [.021])……………………………………………………...
$
17.
Estimated Taxes Withheld from Wages…………………………………………………………………………………….
$
18.
Tax due after Withholding (Line 16 less Line 17) STOP if this amount is less than zero...…………………………..
$
19.
Declaration Due (25% of Line 18) ………………………………………………………………………………………...
$
20.
Less credits (from Line 14 above) or amounts already paid on this year’s liability……………………………………
$
21.
Net estimated tax due if Line 19 minus Line 20 is greater than zero*…………………………………………………..
22.
TOTAL AMOUNT DUE—Combine Line 11 above with Line 21 (
)
$
Make checks payable to the City of Cincinnati
st
*Subsequent estimated payments are due by the 31
of July, October and January.
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.
Paid Preparer Name
PTIN
Signature of Taxpayer or Agent
Date
May the City Tax Division
discuss this return with the
preparer shown to the left?
Name of Firm or Employer
Signature of Spouse
Date
(
) YES
(
) NO
Address of Firm or Employer
Telephone Number
Daytime Telephone Number
1