Income Tax Form - City Of Brook Park - 2016 Page 2

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City of Brook Park, Ohio Income Tax return Application for Automatic Extension of Time To File 2016 Tax Return.
FORM
BPERT
This is not an extension of time to pay your tax.
Last­name,­first­and­initial
Your social security number
Corporate / Company Name
Account­#
If­a­joint­return,­spouse’s­first­name­and­initial
Spouse’s­social­security­number
Contact Person
Federal­Identification­#
Home­address­(number,­street,­and­apt.­no.)
Account­#
Business­Address
City, state, and ZIP code
Phone­#
City, state, and ZIP code
Extension­granted­until­10/16/17­or­copy­of­Federal­Extension­request­is­submitted­to­Brook­Park­Tax­Dept.­with­
For­calendar­yr­2016;­Request­extension­of­time­to:­______________________________________________
tax­return.­Declarations­of­Estimated­Tax­for­2017­are­due­by­4/18/17.­Schedule­C,­E­and­F­filers­are­not­subject­
to­Uniform­Net­Profits­Base.
For­fiscal­year­end:­­_______________________________________________________________________
Request­extension­time­to:­­_________________________________________________________________
Under­ penalties­ of­ perjury,­ I­ declare­ that­ I­ have­ examined­ this­ form,­ including­ accompanying­ schedules­ and­
statements, and to the best of my knowledge and belief, it is true, correct, and complete; and, if prepared by
If­no­dates­entered,­10/16/17­will­be­used.­­­­­
Payment­of­$­_____________________________
someone­other­than­the­taxpayer,­that­I­am­authorized­to­prepare­this­form.
Enclosed­for­­__________________­QTR,­­________________­­Year
Your­Signature­
­
­
­
­­­­­­­­­­­­­Date
Officer’s­Signature­
­
­
­
­
­­­­­Date
The City of Brook Park Tax department does not accept or process E-FILE submissions from commercial tax software packages.
INSTRUCTIONS FOR PREPARING CITY OF BROOK PARK 2016 INCOME TAX FORM
WHO MUST FILE:­The­City­of­Brook­Park­Tax­ordinance­requires­that­all­Brook­Park­residents­(18­years­and­older)­whether­or­not­their­municipal­tax­has­been­fully­
withheld­by­their­employers,­must­file.­­Also,­partnerships,­corporations­and­any­other­entity­or­person­that­is­resident­to­Brook­Park,­or­has­income­taxable­by­the­city­
of­Brook­Park­must­file.­FAILURE TO FILE A RETURN, EVEN IF NO TAX IS DUE, WILL RESULT IN AN AUTOMATIC FINE OF AT LEAST $25.00, AND ANY LOSS
CARRY FORWARD PRIVILEGE WILL BE FORFEITED.
LOTTERY WINNINGS: As­of­January­1,­2004­are­taxable,­and­need­to­be­included­in­income.
WHEN, WHERE TO FILE:­File­with­the­Department­of­Taxation­on­or­before­April­18­following­the­close­of­the­tax­year.­Fiscal­year­taxpayers­shall­file­on­or­before­the­
15th­day­of­the­fourth­month­following­the­close­of­their­fiscal­year.­Extensions­may­be­filed­with­this­office­in­order­to­avoid­paying­a­late­fee.­Checks­or­money­orders­
should be made payable to The City of Brook Park. If payment is not included, the return is not considered timely filed.
EXTENSION OF TIME FOR FILING RETURN (NOT PAYMENT OF TAX): An­extension­request­form­has­been­included­for­your­convenience.­If­you­need­additional­time,­
submit­either­the­form­provided­or­submit­a­copy­of­your­federal­extension.­Requests­must­be­received­by­April­18,­2017,­or­by­the­15th­day­of­the­fourth­month­following­
the­close­of­your­fiscal­year­end.­If­a­federal­extension­request­is­not­submitted­with­the­annual­return,­a­minimum­penalty­of­twenty­five­($25.00)­dollars­will­be­charged­
for­untimely­filing,­and­any­loss­carry­forward­privilege­will­be­forfeited.­­Extensions­may­be­denied­for­untimely­filing,­outstanding­delinquencies­on­account­or­failure­to­
file­required­return,­report,­or­other­related­document­for­a­prior­period.
TAX PAID TO OTHER CITIES: Multiply­each­separate­W-2­form­by­2%­to­calculate­the­tax­credit.­If­the­actual­tax­paid­is­greater­than­the­calculated­tax­credit,­you must
use the calculated tax credit. If the actual tax paid is less than the calculated tax credit, you must use the actual tax paid. Tax credits will not be given for cities which
have­over­withheld,­we­suggest­you­file­for­a­refund­from­those­cities.­Tax­credits­are­prorated­for­those­cities­which­have­changed­their­tax­rate­during­the­year.­There­is­
no­reciprocity­between­cities.­If­you­are­a­non-resident­filing­because­you­work­in­Brook­Park,­do not take credit for tax paid to your resident city. Do not deduct, or take
credit­for­income­tax­payments­made­to­schools.­­If­filing­2106­expenses­reduce­the­tax­amount­paid­to­other­Cities­appropriately.­­­Record­W-2­information­in­Box­1­of­ ­
the­City­of­Brook­Park­return.­Payment­is­due­with­the­filing­of­the­return.
SIGNATURE: Sign­and­date­your­return,­a­return­is­not­“filed”­within­the­meaning­of­the­law­until­signed­by­the­taxpayer­or­an­agent­legally­authorized­to­sign­tax­returns­
for such taxpayer. Initial the box if you want the tax department to discuss your return with the preparer noted.
PENALTY, AND OR INTEREST: A­ penalty­ will­ be­ issued­ for­ failure­ to­ file­ and/or­ pay­ taxes­ when­ due,­ refusal­ to­ make­ ­ estimated­ tax­ payments­ and­ refusal­ to­ file­
extensions.­Minimum­late­file­fee­is­$25.00,­and­increases­to­$150.00­for­each­month­late.­
NET PROFITS: Net­profits­for­individuals­shall­consist­of­Federal­Schedule­C,­E­or­F.­All­others­compute­municipal­adjusted­federal­income­commencing­with­federal­
taxable­income­as­determined­under­the­internal­revenue­code­for­C­corporations­before­net­operating­losses­and­special­deductions­and­adjusted­to­the­requirements­
of the Brook Park ordinance.
BEGINNING WITH TAX YEAR 2016 SEE SCHEDULE B TO COMPUTE RESIDENT NON-WAGE INCOME. THESE CHANGES WERE
MANDATES FROM THE STATE OF OHIO. SEE ORC. 718.01.
ATTACHMENTS REQUIRED ON ALL RETURNS: FOR INDIVIDUALS W-2’S, W-2G’S, 1099’S, LOTTERY WINNINGS, AND THE FIRST PAGE OF THE APPROPRIATE
FEDERAL 1040 (EZ, A, X, etc.)­ORD,­1809.01.­IF­SUBMITTING­FORM­2106,­ALSO­ATTACH­FEDERAL­SCHEDULE­A­AND­REDUCE­BY­THE­2%­IRS­REQUIREMENT.­
IF­ LINE­ 4­ IS­ THE­ SOLE­ ENTRY­ ON­ FORM­ 2106,­ DO­ NOT­ SUBMIT­ UNLESS­ACCOMPANIED­ BY­ PROOF­ OF­ COMPLIANCE­ WITH­ IRS­ GOVERNING­ RULES.­
REGARDING­BUSINESSES,­INCLUDE­ALL­APPROPRIATE­FEDERAL­FORMS­ALONG­WITH­SCHEDULES­AND­APPLICABLE­WORKSHEETS.
DECLARATION OF ESTIMATED TAX: Based­on­the­City­Ordinance,­any­person­anticipating­owing­more­than­$200.00­for­2017­must­complete­this­section­and­quarterly­
payments­must­be­made.­Nonpayment­of­estimated­tax­will­subject­taxpayer­to­a­penalty.­To­avoid­a­fine,­ninety­percent­of­the­tax­due­must­be­paid­by­December­15,­
2017­or­at­least­an­amount­equal­to­the­tax­paid­on­the­prior­years­return,­if­that­return­covered­a­full­twelve­month­period.­Accuracy­of­the­declaration­is­the­taxpayer’s­
responsibility­ and­ can­ be­ amended­ at­ any­ time.­Amendments­ are­ recommended­ if­ your­ job­ situation­ has­ changed­ or­ you­ have­ moved­ out­ of­ the­ city.­You­ may­ pay­
the­estimate­in­full­with­the­return­or­at­any­time­on­or­before­12/15/17.­Any­balance­due­will­be­billed­over­the­next­three­quarters.­Payments­can­be­made­by­cash,­
check,credit card or via tax connect online payment system.

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