Form Fr 1089 - Individual Income Tax Return - Madeira - 2009
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1FORM FR
1089
INDIVIDUAL - 2009
INCOME TAX RETURN
MAKE CHECK OR MONEY ORDER TO:
Taxpayer's Social
CITY OF MADEIRA
Security No.
MADEIRA
HomeTelephone No.
BusinessTelephone No.
Due Date 04/15/2010
INCOME TAX DEPT
7141 MIAMI AVE
Spouse's Social
CINCINNATI OH 45243
Attach all W-2 forms
Security No.
Attach all federal schedules for income
Spouse's
reported on line 2
Name
Voice 513-272-4212 Fax 513-272-4211
HomeTelephone No.
BusinessTelephone No.
Filing Status
IF YOU HAVE MOVED DURING
Name
TAX YEAR - GIVE DATES
RESIDENT
Single
INTO
/
/
Married filing joint
NON-RESIDENT
And
Married filing separate
/
OUT OF
/
IF YOU RENT, PLEASE GIVE LANDLORDS INFORMATION
Address
NAME
ADDRESS
Income
1 Wages, salaries, tips,etc.
1
2 Other taxable income
2
3 Total taxable income (add lines 1 and 2)
3
Tax and Credits
4 Madeira tax due before credits (1.000% of line 3)
4
5 Estimated tax payments made to Madeira
5
6 Taxes withheld and paid to Madeira
6
7 Overpayment from prior year(s)
7
8 Taxes withheld and paid to other localities
Credit is limited to .9% of income taxed by other localities outside of Madeira.
8
9 Total credits (add lines 5 through 8)
9
Refund
( Issued if greater than 1.00 )
10 If line 9 is greater than line 4, subtract line 4 from line 9. This is the amount you overpaid
10
11 Amount of line 10 to be credited to next years estimate
11
12 Amount of line 10 to be refunded
12
Tax Due
( if greater than 1.00 )
13 If line 4 is more than line 9, subtract line 9 from 4, this is the tax amount you owe
13
14 Penalties and interest
Late File __________
Late Pay __________
Late Estimate_______
Interest __________
14
Declaration of Estimate For 2010
15 Estimated income
15
16 Estimated tax due. Multiply line 15 by 1.000%
16
17 Taxes to be withheld and paid to Madeira and other localities
17
18 Prior credit applied to estimated tax payments (From line 11)
18
19 Net estimated tax due (subtract line 17 and 18 from 16)
19
20 Minimum amount due for first quarter (multiply line 19 by .25)
20
Amount You Owe
21 Total amount due (add lines 13, 14 and 20)
21
Tax Office Use Only : Tax Office Use Only : Tax Office Use Only
Since 1-1-08 the allowable credit for tax paid other
localities is .9%.
Taxpayer's Signature
Date
Spouse's Signature
Date
Tax Preparer's Signature
Date
(If other than taxpayer)
Phone No.
May CITY OF MADEIRA discuss this return with the preparer shown above ___Yes ___No
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