Form Ir-22 - City Income Tax Return For Individuals - 2009
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1
22009
IR-22
City of Columbus, Income Tax Division
BEGINNING Jan. 1st or
City Income Tax Return For Individuals
ENDING Dec. 31st or
Check the appropriate box if:
Your social security number
Name(s) and Current Address
REFUND
(An amount must be placed
in Line 6B for this return to be considered
a valid refund request).
Spouse’s social security number
AMENDED
tax year
Married-Filing Separate
Single
Filing Status
Married-Filing Joint
•Did you change residence during 2009?
YES
NO
If YES, enter date of move
Part A
•Should your account be inactivated?
YES
NO
Attach all forms W-2 and applicable Federal schedules and/or documentation - TO BACK
If YES, explain
Employer(s) and address where work performed
Part A
Did you file a City return in 2008?
YES
NO
•
TAXABLE WAGES
(see Page 2 for Adjustments to Taxable Wages)
•City(ies) of Employment/Income #1
#2
(+)
$
•City of Residence
•Occupation or nature of business:
City
Tax
City
Tax
(+)
$
City
Code
Rate
City
Code
Rate
*
Columbus
01
2.125%
Harrisburg
(UFR)
16
1.0%
ADJUSTMENTS
Brice
14
2.0%
Marble Cliff
13
2.0%
(-)
$
Canal Winchester
11
2.0%
Obetz
10
2.0%
Groveport
09
2.0%
UFR =
Universal Filing Requirement of all
*
NET WAGES (enter in Column B below)
(=)
$
See instructions
residents of this community.
Part B
2009 TAX CALCULATION
If you file with more than two cities, call 645-7370 and request Form IR-25.
C
Column A
Column B
Column C
Column D
Column E
Column F
Column G
O
LESS TAX WITHHELD (W-2),
TAX
INCOME FROM WAGES,
INCOME FROM NET
TOTAL NET TAXABLE
NET TAX DUE
CITY
TAX DUE
PAID BY A PARTNERSHIP OR
D
SALARIES, COMMISSIONS
PROFITS, RENTS AND
RATE
INCOME
PAID DIRECTLY TO CITY
E
ETC. (SEE NET WAGES)
OTHER TAXABLE INCOME
WHERE INCOME WAS EARNED
(Pg. 2)
*ALTERNATE CITY
*
ALTERNATE CITY LINE - see instructions
1
$
1. TOTAL NET TAX DUE (TOTAL OF COLUMN G) .................................................................................................................................
2. LESS CREDITS FOR ESTIMATED TAX PAYMENTS AND OVERPAYMENT FROM PRIOR YEAR RETURN ONLY.......
2
$
3
$
3. BALANCE DUE (LINE 1 LESS LINE 2). 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
$
5. TOTAL AMOUNT DUE (ADD LINES 3 AND 4). NOTE: NO PAYMENT IS DUE IF AMOUNT IS LESS THAN $1.00
6
$
6. OVERPAYMENT CLAIMED (IF LINE 2 EXCEEDS LINE 1)...............................................................................
CARRY THIS AMOUNT TO LINE 8
6A $
A.
CREDITED
...
ENTER THE AMOUNT FROM LINE 6 YOU WANT
TO YOUR NEXT YEAR TAX ESTIMATE
6B
B.
REFUNDED
$
ENTER THE AMOUNT FROM LINE 6 YOU WANT
(MUST BE GREATER THAN $1.00)
Part C
2010 DECLARATION OF ESTIMATED TAXES
A declaration of estimated tax is required if all taxes are not fully withheld.
Column H
Column I
Column J
Column K
Column L
Column M
Column N
C
ESTIMATED INCOME
ESTIMATED INCOME FROM
TOTAL
TAX
LESS TAX TO BE WITHHELD
O
ESTIMATED
ESTIMATED TAX DUE
CITY
NET PROFITS, RENTS AND
(W-2) PAID BY A PARTNERSHIP
FROM WAGES, SALARIES,
NET ESTIMATED
RATE
D
NET TAX DUE
OR PAID DIRECTLY TO CITY
OTHER TAXABLE INCOME
COMMISSIONS - ETC.
E
INCOME
WHERE INCOME WAS EARNED
*ALTERNATE CITY
7
$
7. TOTAL NET ESTIMATED TAX DUE (TOTAL OF COLUMN N) ...............................................................................................................
8. OVERPAYMENT CREDITS FROM PREVIOUS YEAR RETURN (FROM LINE 6A) ..............................................
$
8
9. TOTAL CREDITS (AMOUNT FROM LINE 8)...................................................................................................
9
$
10. UNPAID BALANCE DUE (SUBTRACT LINE 9 FROM LINE 7)..........................................................................
10
$
11. LESS AMOUNT PAID WITH THIS DECLARATION (A minimum 25% of Line 7 due now).........................................................................
11
$
12. ESTIMATED TAX BALANCE PAYABLE IN EQUAL INSTALLMENTS EACH QUARTER (Line 10 less Line 11) ..........
12
$
13. TOTAL (ADD LINE 5 [if positive] AND LINE 11)
13
$
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
(
)
SSN
Designee
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.
Sign
Payment Enclosed:
Your
Here
Make payable to:
CITY TREASURER
Signature
Date
Mail to:
Columbus Income Tax Division
If a joint return,
Spouse’s
PO Box 182158
Date
both must sign.
Signature
Columbus, Ohio 43218-2158
Paid
SSN/EIN
NO Payment Enclosed:
Preparer’s
Mail to:
Columbus Income Tax Division
Date
Signature
Phone No.
(
)
Use Only
PO Box 182437
Columbus, Ohio 43218-2437
RESET FORM
PRINT
Rev. 10/21/09
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