Form R-I - City Of Dayton, Ohio Income Tax Return Form Individual Or Joint Filing 2006 Page 2
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2Tax Year ____________ Worksheet
Account Name_______________________ Account # or SS#__________________________________
SECTION D Retired and Taxpayers with NO TAXABLE INCOME check appropriate explanation(s)
[ ] Retired with No Taxable Income
[ ] All Tax Withheld @ 2.25% By My Employer
[ ] Lived and Worked Outside Of Dayton
[ ] Active Duty Military
[ ] Business or Rental Sold on __________________ to _________________ or Closed on ______________
[ ] I certify that I had NO Schedules E, C, K1, 2106, 4797, or 1099-MISC. income or losses reported on my Federal Tax Return.
SECTION A
TOTAL W-2 WAGES
Employer's Name
Work Address
Dayton tax
Other City Tax Total Taxable Wages*
Total Taxable Wages
*Total Taxable Wages: Box 5 is usually, but not always, the highest gross wage. Use the largest amount from boxes
1, 3, 5, or 18, of your W-2 tax forms. Please provide a written explanation if Box 5 is not the highest wage figure.
SECTION E
OTHER INCOME OR LOSS AND FORM 2106 EXPENSE
List all income as reported to the IRS on each of the following attached Schedules or Forms.
Profit and/or Loss
Profit and/or Loss
Profit and/or Loss
Schedule C
Form 4797
Schedule K-1
Schedule C
Schedule K-1
Form 1099-MISC
Schedule E
Form 1099-MISC
Other
Schedule E
Form 1099-MISC
Other
Total to Line 2
Total to Line 2
Total to Line 2
Please note losses are not deductible against W-2 wages.
T otal to Line 2. Form 2106 expenses are deductible from wages.
Form 2106 Expenses: _______________________________
SCHEDULE Y
ALLOCATION OF PROFITS
A. Located everywhere
Schedule Y
B. Located in Dayton
C. Percentage (b/a)
1. Original Cost of Real and Tangible Personal Property
Gross Annual Rentals Paid Multiplied by 8
Total Step 1
2. Gross Receipts from Sales Made and/or Work or Services Performed
3. Wages, Salaries and Other Compensation Paid
4. Total Percentages
5. Average Percentage (Total Percentages/Number of Percentages Used)
Additional addresses or comments:
Important Information: Mail Return with:
PAYMENT DUE to:
City Of Dayton
Dayton, Oh 45401-8746
Division of Revenue and Taxation
PO Box 8746
NON-PAYMENT to:
City Of Dayton
Dayton, Oh 45401-1830
Division of Revenue and Taxation
PO Box 1830
REFUND REQUEST to:
City Of Dayton
Dayton, Oh 45401-1823
Division of Revenue and Taxation
PO Box 1823
Completed Tax Returns will be accepted through the Fax as an original document. All necessary information and
attachments must be included. Income tax preparation service will be provided only to those households earning $35,000 or less.
In the event your check is returned unpaid for insufficient funds or uncollected funds, we may electronically debit your account
for the principal amount of the check.
A return check fee as set forth by the Director of Finance will be assessed. Currently the return check fee is $25.00.
Forms are available at
Online tax preparation tool:
Forms line 937-333-3501
E-mail for forms:
Forms Available: Office Hours: Monday through Friday 8:00 AM to 5:00 PM City Hall, First Floor Lobby, 101 W Third St. Dayton, Ohio 45402
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