City Of Massillon, Ohio Income Tax Return Form 2005
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1
2City of Massillon, Ohio Income Tax Return
METHOD OF PAYMENT - IF PAYING BY CHECK
Tax Office Use Only
OR MONEY ORDER MAKE PAYABLE TO:
One James Duncan Plaza SE • P.O. Box 910 • Massillon, OH 44648-0910
PROCESSED
(330) 830-1709 • Fax (330) 830-2687 •
“CITY OF MASSILLON”
For calendar year ending December 31, 2005
BY ____________________
2005
VISA
MC
Amt____________
CASH
Check
DUE DATE – APRIL 17, 2006
CHECK
M/O
ACCT. # _________________________________
FILING REQUIRED IF NO TAX DUE
EXP. DATE: _______________________________
SIGNATURE______________________________
$ __________________
TAXPAYER SOCIAL SECURITY #
SPOUSE’S SOCIAL SECURITY #
Indicate Filing Status ______ Individual ______ Joint Return ______ Other
PRINT NAME and ADDRESS IF MISSING (Indicate Changes)
BIRTH DATE ______________________________________________________
Home Phone (
)
Work Phone (
)
Are you or the business entity a resident
(
) Yes
(
) No
Moved INTO MASSILLON on _________________________________________
PREV. ADDRESS __________________________________________________
Moved OUT OF MASSILLON on ______________________________________
PRESENT ADDRESS _______________________________________________
IF EXEMPT FROM FILING TAX RETURN ENTER CODE # (See reverse side)
#
TAX PAID TO
MASSILLON TAX
TOTAL W-2 & 1099
EMPLOYER’S NAME
WHERE EMPLOYED
ALL
OTHER CITIES
PAID
WAGES
W-2 & 1099
COPIES
MUST
BE
ATTACHED
TOTAL
$
$
$
1.
WAGES AND SALARIES - Use highest dollar amounts on each W-2
1. $________________
2.
Total adjustments from Back of Form (if applicable) - Losses cannot reduce W-2 earnings
2. $________________
3.
Wages earned outside Massillon by part year non-resident or prior to 18th birthday
3. Deduct $________________
4.
Allowable Employee Business Expenses
(Documentation required. See instruction sheet)
4. Deduct $________________
5.
Taxable Income (Add Lines 1 and 2 subtract Lines 3 and 4)
5. $________________
6.
Massillon City Tax (1.8% of Line 5)
6. $________________
7.
CREDITS
(a) Massillon income tax withheld by employer(s)
7a. $________________
(b) Municipal Tax paid to other cities (Cannot exceed 1.8% of income earned in each location) 7b. $________________
(c) Payment of Declaration of Estimated Tax
7c. $________________
(d) TOTAL CREDITS (add a, b, c)
7d. $________________
8.
BALANCE DUE (If Line 6 exceeds Line 7d enter difference here)
8. $________________
9.
Overpayment claimed (If Line 7d exceeds line 6)
9. $________________
10.
Credit to 2005 Estimate (If no estimate due use Line 11)
10. $________________
11.
TO BE REFUNDED (If estimate due use Line 10)
11. $________________
12.
Late filing fine - (returns filed after filling deadline), enter $25.00 fine
12. $________________
13.
INTEREST - 1% PER MONTH- EFFECTIVE THE FIRST DAY OF EACH MONTH
13. $________________
14.
PENALTY - 1% PER MONTH FOR 1st SIX MONTHS - 2% PER MONTH THEREAFTER ________________________
14. $________________
MUST BE PAID IN FULL WITH THIS RETURN
15.
Total amount due -
15. $________________
NO TAXES OF LESS THAN $5.00 SHALL BE COLLECTED OR REFUNDED
MANDATORY DECLARATION OF ESTIMATED TAX FOR 2006
(NO ESTIMATE DUE IF TAX DUE IS $100.00 OR LESS)
Must be filed
1.
Total income subject to Massillon tax $______________________ Massillon tax @ 1.8%
1. $________________
if a local
2.
LESS TAX TO BE WITHHELD
2. $________________
tax is
3.
Balance estimated Massillon tax
3. $________________
not withheld
4.
Less Credits: a. Overpayment on previous year’s return
4a. $________________
by your
b. Other (Specify)
4b. $________________ Total Credits $________________
employer
5.
Net Tax due (line 3 less total of line 4)
5. $________________
6.
Amount paid with this return (not less than 1/4 X line 3 minus line 4) Make remittance payable to: City of Massillon
6. $________________
I CERTIFY I HAVE EXAMINED THIS RETURN (INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS) AND TO THE BEST OF MY
KNOWLEDGE, I BELIEVE IT IS TRUE, CORRECT, AND COMPLETE.
Signature of Person Preparing, If Other Than Taxpayer
Date
Signature of Taxpayer Required
Date
Address or Name and Address of Firm
Preparers Phone
Spouse’s Signature
Date
File this return with MASSILLON TAX DEPARTMENT on or before April 17, 2006 or within 4 months after close of a fiscal
year or period. Requests for extensions must be submitted in writing on or before the filling deadline.
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