Form Ir-25 - City Income Tax Return For Individuals - City Of Columbus Income Tax Division - 2009

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FOR THE YEAR
2009
IR-25
City of Columbus, Income Tax Division
BEGINNING
City Income Tax Return For Individuals
ENDING
Your social security number
Name(s) and Current Address
Check the appropriate box if:
REFUND
(An amount must be placed
in Line 6B for this return to be considered
Spouse’s social security number (if joint)
a valid refund request.)
AMENDED
tax year
•
Filing Status - check only one
Did you change residence during 2009?
YES
NO
Single
If YES, enter date of move
•
Should your account be inactivated?
YES
N O
Married-Filing Joint
If YES, explain
Married-Filing Separate
•
YES
Did you file a City return in 2008?
N O
Attach all forms and applicable Federal schedules and/or documentation to the back of this return.
•Occupation or nature of business:
Employer(s) and address where work performed
GROSS WAGES
Part A
(+)
$
•Trade name:
•City of Employment/Income #1
(+)
$
•
City of Employment/Income #2
LESS FEDERAL FORM 2106
(-)
$
(if applicable - you must attach a copy)
•
City of Employment/Income #3
NET WAGES (enter in Column B below)
(=)
$
•City of Residence
Part B
TAX CALCULATION
A Declaration of Estimated City Tax (form IR-21) is REQUIRED for all individuals whose tax is not fully withheld.
**
Column B
Column C
Column D
Column E
Column F
Column G
Column A
C
TAX
O
LESS TAX WITHHELD (W-2)
CITY
INCOME FROM NET
INCOME FROM WAGES,
TOTAL NET
TAX DUE
NET TAX DUE
RATE
PAID BY A PARTNERSHIP OR
D
SALARIES, COMMISSIONS,
PROFITS, RENTS AND
TAXABLE INCOME
PAID DIRECTLY TO CITY WHERE
E
OTHER TAXABLE INCOME
ETC. (SEE NET WAGES)
INCOME WAS EARNED
***
01
2.125%
C O L U M B U S
2.0%
GROVEPORT
09
2.0%
10
O B E T Z
11
2.0%
CANAL WINCHESTER
13
2.0%
MARBLE CLIFF
2.0%
14
B R I C E
**
(UFR)
1.0%
H A R R I S B U R G
16
* A LTERNATE CITY
*Alternate City Line (see Instructions)
***See instructions
**NOTE: residents of Harrisburg may only take credit for taxes paid or withheld to their resident city (Column F). UFR = Universal Filing Requirement - residents must file a return.
1
$
1. TOTAL NET TAX DUE (TOTAL OF COLUMN G)...................................................................................................................................
2 $
2. LESS CREDITS FOR ESTIMATED TAX PAYMENTS AND OVERPAYMENT FROM PRIOR YEAR RETURN ONLY .......
3. BALANCE DUE (LINE 1 LESS LINE 2).
.......................
3
$
If Line 2 is greater than Line 1, enter amount (in brackets) here and carry to Line 6.
4. PENALTY: 10% $_____________ + INTEREST $_____________ = .....................................................................................................
4
$
(see instructions)
(see instructions)
5. TOTAL AMOUNT DUE (ADD LINES 3 AND 4). NOTE: NO PAYMENT IS DUE IF AMOUNT IS LESS THAN $1.00.......................................
5
$
6
$
6. OVERPAYMENT CLAIMED (IF LINE 2 EXCEEDS LINE 1) .............................................................................
6A
$
A. Enter the amount from Line 6 you want CREDITED to your next year tax estimate...........
$
6B
B. Enter the amount from Line 6 you want REFUNDED (must be greater than $1.00)
(COMPLETE
Part C
INCOME FROM SOURCES OTHER THAN WAGES, SALARIES, COMMISSIONS, ETC.
REVERSE SIDE OF
B
FORM FIRST)
C
CITY
Column H
Column I
Column J
Column K
O
INSERT APPLICABLE
INCOME (OR LOSS) FROM
OTHER INCOME FROM
TOTAL OTHER INCOME
D
RENTAL INCOME (OR LOSS) FROM
CITIES BELOW
PART D, PAGE 2 OR SCHEDULE Y
PART E (SECTION 2), PAGE 2
(OR LOSS)
E
PART E (SECTION 1), PAGE 2 OR SCHEDULE Y
Third
Do you want to allow another person to discuss this matter with the City of Columbus?
(see instructions)
YES Complete the following
NO
Party
Designee’s
Phone
(
)
Designee
SSN
Name
No.
The undersigned declares that this return (and accompanying schedules) is a true, correct and complete return for the taxable period
MAILING INFORMATION
stated, and that the figures used are the same as used for federal income tax purposes and understands that this information may
be released to the tax administration of the city of residence and the I.R.S.
Payment Enclosed:
Sign
Your
Make payable to:
CITY TREASURER
Date
Here
Signature
Mail to:
Columbus Income Tax Division
If a joint return,
Spouse’s
PO Box 182158
Date
both must sign.
Signature
Columbus, Ohio 43218-2158
NO Payment Enclosed:
Paid
SSN/EIN
Mail to:
Columbus Income Tax Division
Preparer’s
Date
Signature
PO Box 182437
(
)
Phone No.
Use Only
RESET FORM
PRINT
Columbus, Ohio 43218-2437
Rev. 10/21/09

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