Form Ir - Income Tax Return - Batavia
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1
2NOTE:
Page 2 must be completed
if you have taxable rental property or business
income.
1. WAGES, SALARIES, TIPS AND OTHER EMPLOYEE COMPENSATION (ATTACH ALL W2's)
''''''''''''''''''''''''''''''''''''''''''''''
$
2.
OTHER TAXABLE
INCOME
(SEE INSTRUCTIONS)
$
3. TAXABLE INCOME:
LINE 1, PLUS LINE 2
$
4.
MUNICIPAL TAX 1% OF LINE 3
$
5. CREDITS
a. TAX WITHHELD BY EMPLOYER FOR BATAVIA
$
b.
ESTIMATED TAX PAIDTHIS MUNICIPALITY
$
c.
TAX PAID CITY OR VILLAGE OF
(NOT TO EXCEED 1%). $
d.
PRIOR YEAR OVERPAYMENTS
$
e. TOTAL CREDITS
$
@
IF LINE 4 GREATER THAN LINE 5E PAYMENT OF BALANCE MUST ACCOMPANY THIS RETURN:
I
FOR TAX OFFICE USE ONLYI
I
TAX DUE
$
PENALTY $
7.
OVERPAYMENT:
$
INTEREST $
TOTAL $
TO BE:
REFUNDED
$
DECLARATION OF ESTIMATED TAX FOR YEAR
(MUST BE COMPLETED)
MULTIPLY
BY TAX RATE OF 1% FOR GROSS TAX OF
$
CREDITED $
B. TOTAL INCOME SUBJECT TO TAX $
9. LESS EXPECTED TAX CREDITS
a. TAX' WITHHELD BY EMPLOYER (NOT TO EXCEED 1%)
$
b. OVERPAYMENT FROM PRIOR YEAR
$
c.
PAYMENTS TO ANOTHER MUNICIPALITY (NOT TO EXCEED 1%)
$
d. TOTAL CREDITS
,
$
10. ESTIMATED NET TAX DUE (LINE B LESS LINE 9D)
$
11. AMOUNT PAID WITH THIS DECLARATION (NOT LESS THAN 1/4 OF LINE 10), QUARTERLY PAYMENTS DUE
$
@
BALANCE OF TAX DUE
""""""""""""""'"''''''''''''''''''''''''''''''''''''''''''''''''''
$
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 statements
are
based on all Information
of which preparer
has any knowledge,
Signature of person preparing if other than taxpayer
Date
Signature of taxpayer or agent
TAX DUE
(LINE 6)
$
EST. TAX DUE
(LINE 11)
$
TOTAL SUBMITTED
$
Date
CHECK #
IR
BATAVIA INCOME TAX RETURN
FORM
File With
FILING
REQUIRED
EVEN IF NO TAX DUE
TAX OFFICE
Batavia Income Tax Bureau
FILE ON OR BEFORE
APRIL
30,
PHONE
389 East Main Street
Batavia; Ohio 45103
FOR TAXABLE
YEAR
-
732-2740
TAXPAYER'S
NAME, ADDRESS
NAME OF EMPLOYER
WORK ADDRESS
TELEPHONE:
HOME
BUSINESS
S.S. #-MR
MRS.
IF MOVED SINCE THE PREVIOUS FINAL
RETURN WAS DUE GIVE DATE OF MOVE
INTO CITY
OUT OF
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