Form R - Income Tax Return - City Of Akron, Ohio

Form R

INCOME TAX RETURN

CITY OF AKRON, OHIO

- OFFICE USE ONLY -

TAX YEAR

ACCOUNT NUMBER

BUSINESS FED ID #

Fiscal period __________ to __________

DUE ON OR BEFORE:

YOUR SOCIAL SECURITY #

SPOUSE’S SOCIAL SECURITY #

If your name or address is incorrect or missing, please

DATE MOVED IN OR OUT OF AKRON

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print or type the missing information in the block below.

Businesses -

CHECK APPLICABLE BOX:

IN

OUT

DATE_________

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Sole Proprietor

Rental Income

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DAYTIME PHONE NUMBER

Partnership

LLC

S Corp

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C Corp

Other______________

If mailing address is other than Akron, please provide location of Akron activity

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ENTER TOTAL COMPENSATION RECEIVED, INCLUDING ALL DEFERRED INCOME.

EMPLOYED

LOCALITY WHERE

GROSS WAGE INCOME

AKRON INCOME TAX

TAX PAID to OTHER

PRINT EMPLOYER'S NAME

From

To

EMPLOYED

Largest Figure on W-2

WITHHELD

CITY or JEDD

TOTALS → → → →

(NUMBER OF W-2's & 1099's ATTACHED __________)

1)

2)

3)

** IF NO "OTHER INCOME" (SEE INSTRUCTIONS) AND NO ADJUSTMENTS TO INCOME FROM FEDERAL SCHEDULES, GO TO LINE 13 **

THIS INCLUDES DEFERRED INCOME

4. TOTAL GROSS INCOME (FROM LINE 1 ABOVE) ..............................................

......................................................... (4) $__________________|____

5. OTHER INCOME (ATTACH COPY OF FEDERAL RETURN & SCHEDULES) ................................................... (5) $__________________|____

(SEE INSTRUCTIONS ON "LOSSES")

6. ITEMS NOT DEDUCTIBLE (FROM LINE M, SCHEDULE X ON PAGE 2) ......................................................... (6) $__________________|____

7. ITEMS NOT TAXABLE (FROM LINE Z, SCHEDULE X ON PAGE 2) ................................................................. (7) $__________________|____

8. SUBTOTAL (ADD LINES 5 AND 6; THEN SUBTRACT LINE 7) ......................................................................................................................... (8) $__________________|____

9. AMOUNT (

)% OF LINE 8 ALLOCABLE TO AKRON (BUSINESS ONLY - USE SCHEDULE Y) .......................................................... (9) $__________________|____

10. TOTAL OTHER INCOME ( LINE 8 OR LINE 9 IF ALLOCATING INCOME) ............................................................................................................................................................ (10) $__________________|____

11. ALLOCABLE NET LOSS CARRY FORWARD (SEE INSTRUCTIONS) ................................................................................................................................................................ (11) $__________________|____

12. ADJUSTED NET INCOME SUBJECT TO AKRON TAX (ADD LINES 4 AND 10 AND SUBTRACT LINE 11 IF USED) ............................................................................. (12) $__________________|____

13. AKRON INCOME TAX - 2% OF LINE 12 (OR 2% OF LINE 1 IF ONLY W-2 AND 1099 INCOME ) ........................................................ (13) $__________________|____

14. REFUNDS RECEIVED (INDIVIDUALS ONLY) IN THE TAX YEAR SHOWN ABOVE, FROM OTHER CITIES OR JEDDS ....................... (14) $__________________|____

15. TOTAL INCOME TAX BEFORE CREDITS (ADD LINES 13 AND 14) ................................................................................................................................................................ (15) $__________________|____

16. AKRON INCOME TAX WITHHELD BY EMPLOYERS (LINE 2) .......................................................................... (16) $__________________|____

17. TAX PAID OTHER CITIES OR JEDDS (SEE INSTRUCTIONS) ............................................________............ (17) $__________________|____

18. MINIMUM INCOME CREDIT (SEE INSTRUCTIONS) ........................................................................................... (18) $__________________|____

19. TAX PAID BY PARTNERSHIP OR S-CORP (ATTACH SCHEDULE E OR SCHEDULE K-1) ....................... (19) $__________________|____

20. TOTAL CITY CREDITS (IF LINE 18 IS ZERO, ADD LINES 16, 17 & 19: IF LINE 18 IS NOT ZERO, ADD LINES 16 & 18) .................. (20) $__________________|____

21. ESTIMATED PAYMENTS MADE FOR THIS TAX YEAR (DO NOT INCLUDE PENALTY & INTEREST PAYMENTS) ........................…...... (21) $__________________|____

22. AMOUNT OF PREVIOUS YEAR CREDITS ............................................................................................................................................................ (22) $__________________|____

23. TOTAL CREDITS ALLOWABLE (ADD LINES 20, 21 & 22) ............................................................................................................................................…................................... (23) $__________________|____

24. BALANCE OF TAX DUE (SUBTRACT LINE 23 FROM LINE 15) ........................ PAY IN FULL WITH THIS RETURN ........................................................................... (24) $__________________|____

25. OVERPAYMENT CLAIMED (IF LINE 23 EXCEEDS LINE 15 ENTER DIFFERENCE HERE) ......................... (25) $__________________|____

PEN (29) $__________________|____

26. AMOUNT OF LINE 25 TO BE USED AS CREDIT FOR NEXT YEAR .............................................................. (26) $__________________|____

INT (30) $__________________|____

27. AMOUNT OF LINE 25 TO BE REFUNDED .................................................. (27) $__________________|____

(31) $__________________|____

28. AMOUNT OF LINE 25 DESIGNATED AS A CONTRIBUTION FOR: ................................................................. (28) $__________________|____

(32) $__________________|____

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POLICE EQUIPMENT

FIRE & EMS EQUIPMENT

PARKS & RECREATION EQUIPMENT

(33) $__________________|____

NO TAXES OR REFUNDS OF LESS THAN $1.01 WILL BE COLLECTED OR REFUNDED.

IF REFUND IS DUE PLEASE CHECK BOX ON FRONT OF RETURN ENVELOPE.

Make CHECK payable to: City of Akron, Ohio

and Mail Return to: Income Tax Division, 1 Cascade Plaza - 11th Floor, Akron, OH 44308-1100

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS RETURN, INCLUDING ANY ACCOMPANYING DOCUMENTS, AND TO THE BEST OF MY KNOWLEDGE AND

BELIEF IT IS TRUE, CORRECT AND COMPLETE.

I authorize the Income Tax Division to discuss my tax return and enclosures with my tax preparer.

(Taxpayer's initials are required)

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SIGNATURE OF TAXPAYER

DATE

PREPARER PRINTED NAME IF OTHER THAN TAXPAYER

PHONE #

DATE

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SIGNATURE OF SPOUSE (IF JOINT RETURN)

PREPARER SS/FED ID #

PREPARER ADDRESS