Form Wv-Ez - Income Tax Return Wv -Ez

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CITY OF WESTERVILLE, OHIO
Form WV-EZ
Division of Revenue 64 East Walnut St.
Westerville, Ohio 43081
Check your status as
INCOME TAX RETURN WV -EZ
a resident:
DUE BY APRIL 15TH
Full Yr. ( ) Part Yr. ( )
FOR THE CALENDAR YEAR __________
Did you file a Westerville Return In ________? YES ( ) NO ( )
If Moved During Year Of This Return Give Date of Move
INTO WESTERVILLE
OUT OF WESTERVILLE
Name and Address - If incorrect please make necessary changes above
______________________________________________________________________________________________________
ATTENTION
ALL RESIDENTS OF THE CI TY OF WESTERV ILLE MUST FI LE A TAX RETURN
IF YOU HAVE TAXABLE INCOME YOU MUST FILE THE WESTERVILLE FORM R. HOWEVER, IF YOU
HAVE NO TAXABLE INCOME, COMPLETE THE FORM WV-EZ ( BELOW) AND RETURN THIS FORM WV-EZ
BY APRIL 15th, IN THE ENCLOSED ENVELOPE TO:
DIVISION OF TAXATION
64 EAST WALNUT STREET
WESTERVILLE, OHIO 43081
FOR QUESTIONS OR ASSISTANCE IN PREPARING YOUR RETURN, OR TO ACQUIRE A FORM R, CALL 901-6420 OR
VISIT THE DIVISION OF TAXATION AT 64 EAST WALNUT STREET, WESTERVILLE, OH.
PLEASE CHECK ANY OF THE FOLLOWING INCOME SOURCES YOU HAD:
RETIREMENT PENSION
_____ SOCIAL SECURITY
_____
RENTAL INCOME/LOSS
SELF-EMPLOYMENT
_____
______
PARTNERSHIP INCOME/LOSS
_____ JURY DUTY
_____
VOTING/PRECINT WORK
CONSULTING
_____
_____
_____ PART -TIME JOB
I CERTIFY ALL INFORMATION TO BE TRUE:
______________________________________
SIGNATURE
(DA TE)
______________________________________
SOCIAL SECURITY #
_______________________________________________
SPOUSE, IF JOINT RETURN
(DATE)
_______________________________________________
SOCIAL SECURITY #
White Copy To Westerville/ Canary Copy is Your Copy

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