Individual Income Tax Return - City Of Wooster - 2012
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22012 WOOSTER INDIVIDUAL INCOME TAX RETURN
STANDARD FORM For Calendar Year 2012
Due on or before April 15, 2013
Social Security Number(s)
ESTIMATED PAYMENTS & CREDITS
Your S.S. No.
Spouse's S.S. No. (if joint return)
Information regarding payments and credits for 2012
will be mailed in the middle of February.
Do not write
Complete Name & Address (include spouse's name if joint return)
in this area
MAIL TO:
CITY OF WOOSTER
INCOME TAX DEPT
PO BOX 1088
WOOSTER OH 44691
Questions?
(330) 263-5226
Residency Status (check one that applies)
Type of return (check one)
Individual
Joint
Resident
Non-Resident
Part-Year Resident: From____________ To ____________
INCOME
1a
Wages, salaries, tips, etc. (use box 5 of W-2, if applicable, SEE INSTRUCTIONS)
...…
Attach all
b
………………………….
Less employee business expenses (attach Federal form 2106)
W-2's to
c
1c
………………………………………………….
Subtract line 1b from line 1a and enter the difference
back of
2a
……………………..
2a
Income from Schedule X, line 7b, back of this form (DO NOT ENTER LOSSES)
return
b
……………… (
)
Operating loss carry forward from Schedule X, line 7a, back of this form
3
……………………………………………….
3
Add lines 1c & 2a. This is your TAXABLE INCOME
TAX
4
4
……………………………………….
Multiply line 3 by 1% (.01). This is your Wooster Income TAX
5
…………………………………………………
City income tax withheld for Wooster
PAYMENTS 6
………….
City income tax withheld or paid other cities - Use schedule R (back of form)
7
………………. .
2012 estimated payments and overpayment from 2011 credited to 2012
8
………………………………
Payments made toward 2012 income tax with extension
9
9
……………………………………………………..
Total credits and payments (add lines 5,6,7, & 8)
REFUND
10
….……………………….OVERPAYMENT
10
If line 9 is larger than line 4, enter amount OVERPAID
OR
11
11
. …...…………………………….REFUND
Amount of line 10 to be refunded to you (See instructions)
AMOUNT
12
...….……………………….CREDIT TO 2013
12
Amount of line 10 to be applied to your 2013 estimate
OWED
13
13
…...….………………..AMOUNT OWED
If line 4 is larger than line 9, enter AMOUNT YOU OWE
***IF LINE 4 LESS THE SUM OF LINES 5 AND 6 IS GREATER THAN $200, AND WILL BE OVER $200 FOR
2013, YOU MUST ESTIMATE 2013 INCOME TAX. (SEE INSTRUCTIONS)***
DECLARATION
14
…………………………………………….
2013 Wooster income tax estimate
OF 2013
15
Amount of 2013 estimate due with return (at least 1/4 of line 14; see instructions)
ESTIMATED TAX
16
Credits (2012 overpayment and previous 2013 estimated payments)
17
17
(See Instructions)
…………………………….
Amount of 2013 estimate paid with this return (line 15 less line 16)
18
PAST DUE AMOUNTS
Penalty 1%_________________
Interest 1/2% _________________
Late filing penalty $25.00 imposed 12 months past due date when no tax is due
19 TOTAL PAYMENT DUE WITH THIS RETURN (add lines 13,17 & 18) ………………………
19
Make check payable to "City of Wooster". Please write your social security number on the check and any accompanying schedules.
If line 19 is less than $1.01, payment need not be made. If line 11 is less than $1.01, no refund will be issued.
Under penalties of perjury, I declare that I have examined this return and the accompanying schedules and statements, and to the best of my knowledge and belief,
they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Do you authorize your preparer to contact us regarding this return? Yes 1 No 1
PLEASE
SIGN
Taxpayer's Signature
Date
Paid Preparer's Signature
Date
HERE
Spouse's Signature (if joint return)
Date
Firm or individual
Page 5
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