City Of Massillon, Ohio Income Tax Return Form 2005 Page 2

PROFIT OR LOSS FROM SCHEDULE C & E OR K-1

(A COPY OF THE FEDERAL FORM 1040 AND APPLICABLE SCHEDULES MUST BE ATTACHED)

1.

SCHEDULE C NET PROFIT OR LOSS .................................................................................................................................................................$_______________

2.

SCHEDULE E NET PROFIT OR LOSS .................................................................................................................................................................$_______________

3.

NET PROFIT OR LOSS (Add Lines 1 and 2).........................................................................................................................................................$_______________

4.

ADD ITEMS NOT DEDUCTIBLE ............................................................................................................................................................................$_______________

5.

DEDUCT ITEMS NOT TAXABLE ...........................................................................................................................................................................$(______________)

6.

LESS ALLOCABLE NET LOSS CARRY FORWARD (Five year limit)...................................................................................................................$(______________)

7.

NET PROFIT OR LOSS TAXABLE BY THE CITY OF MASSILLON (Line 3 + Line 4 - Line 5 - Line 6) ...............................................................$_______________

CODES AND REASONS FOR EXEMPTION OF INCOME

CODE #

REASON

001

Retired, Receiving only pension, Social Security, interest or dividends.

002

Under 18 years of age all of 2005. (Attach documentation of date of birth)

003

Active Duty Military for all of 2005.

004

Taxpayer is deceased. Given date of death: _____________________________________________________________________________

005

Moved from Massillon prior to January 1, 2005. Give date of move and new address (Attach required documentation.) __________________

________________________________________________________________________________________________________________

006

On Governmental assistance, received no other income.

007

Received only alimony and/or child support and no other income.

008

Unemployed during all of 2005, received only unemployment compensation and no other income.

009

Disabled during all of 2005, received only Worker’s Compensation.

010

Other: Give reason _________________________________________________________________________________________________

CODES AND REASONS FOR REFUND REQUESTS

CODE #

REASON

011

During 2005, I was under the age of 18 and taxes were withheld. (Attach proof of age: Birth Certificate, Driver’s License, State Identification Card.)

012

Due to the 2106 expense guidelines there is an overpayment. (Attach Federal forms 1040, 2106, and Schedule A.)

013

During 2005, I was only a part-year resident. (Attach documents that prove the move out date.)

014

During 2005, I was a non-resident that worked less than 100% in the City, (Obtain required form from Income Tax Department.)

015

My employer erroneously withheld 1.80% for 2005. (Attach documentation of non-residency and out of City employment.)

016

My employer overwithheld City of Massillon tax for 2005.

017

I overpaid my estimate for 2005.

018

Other: Give reason ______________________________________________________________________(Attach necessary documentation.)

Tax Return Check List

1.

Did you sign your tax return?

5.

If your balance due on line 15 was over $100, did you fill out the

declaration of estimate?

2.

Did you use the highest amount of gross wages on W-2s?

6.

Did you attach proof of age if applicable?

3.

Did you enclose all supporting documentation?

(W-2s, 1099s and all Federal Schedules & Forms)

7.

Did you sign and enclose your check or money order if an amount

is due. Please do not send cash or coins.

4.

If you moved during the year, did you indicate your new

address and provide documentation?