Form 1040-R - Springboro Individual Income Tax Return - 2005

1040-R

2005

2005

FOR ASSISTANCE

SPRINGBORO INDIVIDUAL INCOME TAX RETURN

CALL (937) 748-9701

320 W. Central Ave., Springboro, OH 45066 – DUE ON OR BEFORE

APRIL 17, 2006

FAX (937) 748-6185

FOR FAILURE TO FILE BY APRIL 17, 2006, A MINIMUM $40.00 PENALTY WILL BE ASSESSED

IF NAME OR ADDRESS IS INCORRECT, MAKE NECESSARY CHANGES

TAXPAYER SSN: ______________________________________________

(LIST BOTH NAMES AND SOCIAL SECURITY NUMBERS IF FILING A JOINT RETURN)

SPOUSE SSN: _________________________________________________

HOME PHONE NUMBER:_______________________________________

IF YOU MOVED DURING THE YEAR, COMPLETE THIS SECTION:

DATE OF MOVE: ______________________________________________

FORMER ADDRESS: ___________________________________________

I AM NOT REQUIRED TO COMPLETE SECTION B OF THIS RETURN BECAUSE:

A

______ ACTIVE DUTY MILITARY (Attach W-2)

_______ TAXPAYER DECEASED, LIST DATE OF DEATH __________________________________________

______ NO EMPLOYMENT IN 2005

_______ MOVED FROM SPRINGBORO PRIOR TO 1-1-05, LIST DATE OF MOVE ______________________

______ ONLY INCOME IS FROM A NON-TAXABLE SOURCE – LIST SOURCE: _________________________________________________________________________

(INTEREST, DIVIDENDS, STOCKS, BONDS, CAPITAL GAINS, UNEMPLOYMENT, RETIREMENT INCOME, ETC. IS NOT TAXABLE)

I I

1.

Total from Worksheet A, Column 2 . . . . .Number of W-2s attached

. . . . . . . . . . . . . . . . . . . . . . . . . .1. ____________________

B

2.

Total from Worksheet B, Line 3. (Attach Federal Schedules) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2. ____________________

3.

Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3. ____________________

4.

Total From Worksheet C (Attach Federal Schedules) . . . . . . . . . . .4A. (__________________) . . . . . . .4B. ____________________

5.

Miscellaneous Income (Attach W-2G) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5. ____________________

6.

Total Income (Add lines 3, 4B and 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6. ____________________

7.

Tax Liability – Multiply line 6 by 1.5% (0.015) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7. ____________________

8.

A. Springboro tax withheld (See worksheet A, column 3) . . . . . . . . . . . . . . . . . . . . . . . . .8A. ___________________

B. Credit for other city tax withheld

(Max. credit 1.0% see worksheet A column 6)

. . . . .B. ___________________

C. Estimated taxes paid for 2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C. ___________________

D. Prior year credit carried forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D. ___________________

8E. Total of credits. Add 8A, 8B, 8C and 8D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8E. ____________________

9.

If line 7 is greater than box 8E, enter your balance due here (If less than $10.00, enter 0) . . . . . . . . . . . . . . .9. ____________________

10. If line 8E is greater than line 7, enter your overpayment here (If less than $10.00, enter 0) . . . . . . . . . . . . .10. ____________________

Amount to be: REFUNDED:____________________

or CREDITED TO 2006:___________________

11. Late filing penalty:_____________

Penalty:______________ Interest:____________ . . . . . . . . . . . . . . .11. ____________________

12. BALANCE DUE Add line 9 and line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12. ____________________

DECLARATION OF ESTIMATED TAX DUE FOR TAX YEAR 2006

MANDATORY IF LIABILITY

$25.00 FAILURE TO FILE FEE IF NOT COMPLETED AND

IS $500.00 OR MORE

$50.00 FAILURE TO PAY ACCORDING TO PAY SCHEDULES

13. Total estimated tax due for tax year 2006 (Gross taxable income multiplied by 1.5%) . . . . . . . . . . . . . . . . . . . .13. _____________________

14. Less credits (Including prior year credit from line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. _____________________

15. Net taxes owed for tax year 2006 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. _____________________

16. Amount paid with this declaration (1/4 of amount in box 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16. _____________________

17. TOTAL DUE – ADD BOXES 12 and 16 to arrive at total due with this return . . . . . . . . . . . . . . . . . . . . . . . . .17. _____________________

The undersigned declares that this return (and accompanying W-2’s, schedules and statement) is a true, correct and complete

return for the taxable period stated and that the figures used herein are the same as used for Federal Income Tax purposes. If this

return was prepared by a tax practitioner, may we contact your practioner directly with questions regarding the preparation of the

return? _____ Yes _____ No.

C

Your Signature

DATE

CREDIT CARD NUMBER

Spouse’s Signature

DATE

EXPIRATION DATE

Signature and phone number of preparer if other than taxpayer

DATE

AMOUNT