Form I-8 Long - Cleveland Heights Individual Income Tax Return

FORM I-8 LONG FORM

CLEVELAND HEIGHTS INDIVIDUAL INCOME TAX RETURN

TAX YEAR 2000

MAIL TO: PO BOX 641747, CINCINNATI, OH, 45264-1747

MUST BE FILED BY APRIL 16, 2001

(216) 291-3978

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SS #

THIS YEAR’S FILING STATUS:

JOINT

SEPARATE

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LAST YEAR’S FILING STATUS:

JOINT

SEPARATE

RECENT MOVE DATE:

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From Cleveland Heights

To Cleveland Heights

Previous or New Address (circle one)

City, State, Zip

Home Phone (

)

Work Phone (

)

TABLE I: WAGE INCOME (From Federal Forms W-2 and 1099 Misc.)

COLUMN A

COLUMN B

COLUMN C

COLUMN D

COLUMN E

COLUMN F

List Wages From

Tax Credit Calculation

Municipal

Smaller of

City Withholding

Resident City

Each Employer

(Column A x .01)

Tax Withheld*

Column B and C**

Paid to

not use

(Highest amount on W-2)

(W-2, Box 21)

(W-2, Box 19)

(Usually W-2 Box 5 or 20)

Total

* If no withholding, enter zero in Column C.

** Withholding for Cleveland Heights goes on Line 7a – enter zero in Column D.

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➤ If you want city to calculate tax, STOP, check here, sign, and submit with W-2s before March 15, 2001

TAX CALCULATION WORKSHEET:

INCOME

1a. WAGE INCOME (TABLE I, Column A total)..........................................................................1a

1b. NON-WAGE INCOME earned in Cleveland Heights (TABLE II, Line 6a) ..............................1b

1c. NON-WAGE INCOME earned outside Cleveland Heights (TABLE II, Line 6c)......................1c

2. TOTAL TAXABLE INCOME [Add Lines 1a, 1b, and 1c] ..........................................................2

TAX

3. TAX [Multiply taxable income (Line 2) by 2% (.02)]................................................................................................................3

CREDITS

4a. Wage income limit for tax credit calculation (TABLE I, Column D total) ................................4a

for local tax

paid outside

4b. Non-wage income limit for tax credit calculation (TABLE II, Column B, Line 10) ..................4b

of Cleveland

Heights

5. Total income limit of 1% for tax credit calculation [Add Lines 4a and 4b]................................5

6. TAX CREDIT of

of 1% of income taxed by other locality [Multiply Line 5 by 50% (.50)] ....6

CREDITS

7a. Employer withholding directly to Cleveland Heights (must be on W-2, Box 21) ....................7a

for tax paid to

Cleveland

7b. Your share of business partnership tax: ID #

(Attach K-1 Schedule)..7b

Heights

8. TOTAL CREDITS [Add Lines 6, 7a, and 7b] ..........................................................................................................................8

TAX AFTER

9a. TAX DUE: If credits (Line 8) are LESS than tax (Line 3), ENTER difference here ..............................................................9a

CREDITS

9b. If credits (Line 8) GREATER than tax (Line 3), ENTER difference here................................9b

PAYMENTS

10. 2000 estimated tax paid (plus prior year credits) as of December 31, 2000 ........................10

11. Additional estimated payments made after December 31, 2000 ..........................................11

12. TOTAL PAYMENTS APPLIED TO 2000 [Add Lines 9b, 10, and 11] ....................................................................................12

BALANCE

13. BALANCE DUE: If total payments (Line 12) are LESS than tax due (Line 9a), ENTER balance due ................................13

DUE

14. TAX OVERPAYMENT: If total payments (Line 12) are GREATER than tax due (Line 9a), ENTER overpayment ..............14

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Please check one:

Apply to 2001 Tax Estimate

Refund

ESTIMATE

15. 2001 tax estimate (default is 2000 tax on Line 9a, or use estimate worksheet on back)......15

16. First quarter 2001 estimated payment due [Multiply Line 15 by 25% (.25) and subtract Line 14 if applied to 2001]..........16

(Quarterly estimated payments are due in April, July, October, and January.)

17. TOTAL DUE WITH RETURN [Add Lines 13 and 16] ........................................................................................................17

Under penalty of perjury, the undersigned declares this return to be true and complete:

RETURNS WITHOUT PAYMENT OF TAX DUE

SUBJECT TO 20% PENALTY PLUS INTEREST

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Authorization for City

Taxpayer’s signature

Date

Preparer’s signature (if not taxpayer)

Date

to discuss account with

preparer.

Spouse’s signature