Individual Questionnaire Form - City Of Hamilton
Download a blank fillable Individual Questionnaire Form - City Of Hamilton in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Individual Questionnaire Form - City Of Hamilton with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Submit by Email
Print Form
Phone:
513 785-7400
INDIVIDUAL QUESTIONNAIRE
INDIVIDUAL QUESTIONNAIRE
INDIVIDUAL QUESTIONNAIRE
INDIVIDUAL QUESTIONNAIRE
CITY OF HAMILTON
Toll Free: 1 800 854-1684
HAMILTON – 2%
CHECK APPROPRIATE CITY
EATON – 1.5%
INCOME TAX DIVISION
Fax:
513 785-7401
345 High Street, Suite 310
Email:
citytax@ci.hamilton.oh.us
WEST MILTON – 1.5%
NEW MIAMI – 1.75%
Hamilton, Ohio 45011
Website:
PHILLIPSBURG – 1.5%
USE A SEPARATE FORM FOR EACH CITY
BUTLER COUNTY ANNEX - 2%
Please assist us in completing your account information. If you should have any questions while completing this form,
please contact our office. Mail or fax within 10 business days. Thank you for your cooperation.
Taxpayer Name
_____________________________________________________
Social Security # _____________________________
Address* _____________________________________________________________________________________________________________
*If you have not lived at above address for 7+ years, please list your addresses for the last 7 years from most recent to oldest on the back of this form.
Home Phone # _________________________________________
Daytime Phone # ____________________________________________
Email _________________________________________________
Date moved into City ____________________________________
Do you (Please Check One):
___ Own
___ Rent
___ Lease
If you rent or lease, what is the name and address of your landlord? _______________________________________________________________
_____________________________________________________________________________________________________________________
Type of Income (Please check all that apply)
___ Employed ___ Self-Employed
___ Rental Property Owner ___ Armed Forces ___ Retired
___ Disabled
___ Other ____________
(W2 Wages)
(Schedule C)
(Schedule E)
(Please Specify)
Name of Employer*: ____________________________________________________________________________________________________
Address of Employer: ____________________________________________________________________________________________________
Is local tax being withheld? (Please check one):
___ Yes, name of City ___________________
_____ No
*If you have not worked for above employer for 7+ years, please list all employers for the last 7 years from most recent to oldest on the back of ths form.
For each Employer Include: Employer Name, Address, Start & End Dates, If city tax was withheld list the city that tax was withheld for.
Self-employed: Describe the nature of your work and list the years you have been self-employed _______________________________________
_____________________________________________________________________________________________________________________
Schedule C filers: Date began business(es) in city ___________________________________________________________________________
Schedule E filers: Date purchased rental property and location __________________________________________________________________
If you have multiple rental properties, please list the purchase date and location of each property on the back of this form.
Spouse’s Name
____________________________________________________
Social Security # _____________________________
Address* _____________________________________________________________________________________________________________
*If you have not lived at above address for 7+ years, please list your addresses for the last 7 years from most recent to oldest on the back of this form.
Home Phone # _________________________________________
Daytime Phone # ____________________________________________
Email _________________________________________________
Date moved into City ____________________________________
Type of Income (Please check all that apply)
___ Employed ___ Self-Employed
___ Rental Property Owner ___ Armed Forces ___ Retired
___ Disabled
___ Other ____________
(W2 Wages
(Schedule C)
(Schedule E)
(Please Specify)
Name of Employer*: ____________________________________________________________________________________________________
Address of Employer: ____________________________________________________________________________________________________
Is local tax being withheld? (Please check one):
___ Yes, name of City ___________________
_____ No
*If you have not worked for above employer for 7+ years, please list all employers for the last 7 years from most recent to oldest on the back of ths form.
For each Employer Include: Employer Name, Address, Start & End Dates, If city tax was withheld list the city that tax was withheld for.
Self-employed: Describe the nature of your work and list the years you have been self-employed _______________________________________
_____________________________________________________________________________________________________________________
Schedule C filers: Date began business(es) in city ___________________________________________________________________________
Schedule E filers: Date purchased rental property and location __________________________________________________________________
If you have multiple rental properties, please list the purchase date and location of each property on the back of this form.
Is anyone else in your household working?
___ Yes, Give the person’s Name and Social Security # below
__ No
Name _________________________________________________________________
Social Security # ______________________________
Name _________________________________________________________________
Social Security # ______________________________
Taxpayer Signature _____________________________________________________
Date ________________________________________
Spouse Signature ______________________________________________________
Date ________________________________________
*If submitting by email, no signature is required*
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial