Form Ir - Golf Manor Income Tax Return - 2009
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1
2Village of Golf Manor
20Q9
INDIVIDUAL
FORM IR
FILE WITH
Golf Manor Income Tax Bureau
GOLF MANOR INCOME TAX RETURN
6450 Wiehe Road
Due on of before
APRIL 15, 2010
Golf Manor, Ohio 45237
FILING REQUIRED EVEN IF NO TAX IS DUE
Phone: 531-5155
LATE FILING OF THIS RETURN SUBJECTS YOU TO INTEREST AND A MINIMUM PENALTY OF
$75.00.
LATE PAYMENT OF TAXES DUE SUBJECTS YOU TO INTEREST AND A MINIMUM PENALTY OF
$75.00.
IF TAXPAYER, AND SPOUSEO. ARE FuLL'( ~ETIRED AND
WITHOUT TAXABLE INCOME. PLACE AN
X
IN THtS BOX
D
SIGN, DATE AND RETURN THIS FORM BY THE DUE DATE.
TAXPAYERS NAME(S) AND ADDRESS (CORRECT IF NECESSARY)
EMPLOYER'S
NAME(S):
SPOUSE'S
EMPLOYER:
WORK
PHONE:
CITY WHERE
EMPLOYED:
_
SOCIAL SECURITY NO
(ACCOUNT NUMBER)
REOUIRED
ARE YOU ARESIDENT OF GOLF MANOR?
SPOUSES SOC. SECURITY NO
DID YOU FILE ARETURN FOR LAST YEAR?
HAS INTERNAL REVENUE SERVICE
INCREASED YOUR INCOME TAX LIABILITY
FOR ANY PRIOR YEAR?
IF SO. HAS AN AMENDED VILLAGE OF GOLF
MANOR INCOME TAX RETURN BEEN FILED?
YES
NO
IF YOU ARE A NEW RESIDENT. FILING THE FIRST TIME OR YOU MOVED SINCE FILING YOUR TAX RETURN,
PLEASE FURNISH YOUR CURRENT MAILING ADDRESS AND DATE OF MOVE:
MOVED INTO GOLF MANOR.
MOVED OUT OF GOLF MANOR.
FILING INSTRUCTIONS
ON BACK OF THIS FORM
OFFICE
USE
1.
ENTER TOTAL OF ALL GROSS WAGES, SALARIES, TIPS AND OTHER EMPLOYEE COMPENSATION (ATIACH ALL W·2 FORMS) ..
$ - - - - - - - - - - - -
2
TOTAL OTHER TAXABLE INCOME OR DEDUCTIONS: ENTER AMOUNT SHOWN ON LINE 20 FROM SIDE TWO (BACK) OF THIS FORM
$ - - - - - - - - - - - - -
3.
TOT AL TAXABLE INCOME (LINE 1 PLUS LINE 2) . . . . .. . •...
$
--------~---
4.
GOLF MANOR TAX: 1 7% OF LINE 3.
$ - - - - - - - - - - - -
TAX CREDITS:
A. ENTER TOTAL TAXES WITHHELD BY EMPLOYER(S) FOR THE VILLAGE OF GOLF MANOR. ..
$---------------------
B. ENTER 2009 TOTAL ESTIMATED TAXES PAID TO VILLAGE OF GOLF MANOR
C. ENTER 2009 TAXES PAID CITY OF
(LIMITED TO 1.7%
OF THAT PORTION OF THE INCOME OF EACH W·2 FORM TAXED BY ANOTHER MUNICIPALITY FIGURE EACH
W·2 INDIVIDUALLY.)
$-----------------,..-,-.,-,.......,-
$
--.,..._--'
o
ENTER PRIOR YEAR TAX OVERPAYMENT AMOUNT .....
$--------------------'-
6
7.
E. TOTAL TAX CREDITS (ADD TOGETHER LINES SA THROUGH 5D)
IF LINE 4 GREATER THAN LINE 5E ENTER DIFFERENCE ON THIS LINE •••••••••••••••••.••••••• 2009 TAX DUE AND PAYABLE
$r=======;----~
$I_~-=-_
TO LINE 11
TAX OVERPAID TO BE REFUNDED
$••••••••••
OR CREDITED
$• • • • • • • • • • •
TOWARD NEXTr..,-:Y"::' E ' : "' A R:-::S-,:E,..-S-,:T_IM.,...A_T_E.,...T.,...A_X
..,,---,
~,.__-__.,...---_..,.........,=.,
NO ADDITIONAL TAXES OR REFUNDS OF LESS THAN ONE DDLLAR ($100) SHALL BE COLLECTED OR REFUNDED
I
NOTICE: By law. all refunds and credits in excess of $10.00 are being reponed to IRS
I
OFFICE
A. INTEREST CHARGE
$
,
PENALTV CHARGE
TOTAL ASSESSMENT
$
_
USE
ONLY
B.
UNPAID TAX BALANCE lIN.E
6
$
PLUS TOTAL ASSESSMENT LINE 7A $
• TOTAL AMOUNT DU_E
~
DECLARATION OF ESTIMATED TAX FOR YEAR 2010
6.
ENTER TOTAL ESTIMATED 2010 INCOME $
MULT1PL Y BY TAX RATE
\.7% •
TOTAL 2009 ESTIMATED TAX $
--:-__.,...---
9.
ESTIMATED TAX CREDITS:
A. ESTIMATED TOTAL TAXES TO BE WITHHELD BY EMPLOYER(Sj FOR VILLAGE OF GOLF MANOR.
$-------------------
B. ESTIMATED TOTAL TAXES, NOT OVER
\.7%,
WITHHELD FOR OR PAYABLE TO OTHER CITIES
$--------------------
C. TAX OVERPAYMENT FROM PREVIOUS TAX YEAR.
ENTER AMOUNT FROM LINE 7 REOUESTED TO BE CREDITED TO THIS ESTIMATE.
$--------------------~
D TOTAL ESTIMATED TAX CREDITS: (LINE 9A PLUS LINE 9B
+
9Cl
$--------------~
10.
TOTAL ESTIMATED TAX DUE AND PAYABLE TO GOLF MANOR (SUBTRACT LINE 9D FROM LINE
8) .
$
AMOUNT ENC.LOSED
11.
TOTAL AMOUNT DUE: TAX DUE FOR 2009 (LINE 6) $
PLUS 1142010 ESTIMATED TAX (LINE 10) $
I CERTIFY THAT I HAVE EXAMINED THIS RETURN (INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS) AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE. IF PREPARED BY A PERSON OTHER THAN TAXPAYER, THE DECLARATION IS BASED ON ALL INFORMATION OF WHICH PREPARER HAS
KNOWLEDGE
S,gn.lure
01
Person Preparing
II
O1her Than Taxpayer
Dale
Signalure of Taxpayar (reQurred to be valid)
Dete
COMPI ETE
II~I~S
I. THROIIGH 211
on
Till RACK OF THIS ,onM IF TAXPAYCR AND
OR
SPOlJSl HAVI
I~JC'-.JrAL
I ",-'M SOUHCL", UTHER
THA~I
WAGES MJll UH IF ANY
Signature of JOint Taxpayer
Dale
OErlUCTIONS AHC [3CII'JG Cl AIMlO AGAIIJST WAGC LAHNINGS
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