Indicidual Income Tax Return Form - State Of Ohio
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1RLE WITH:
Westfield Center
Income Tax Dept
P.O. Box 750
Westfield Center, OH 44251
Phone (330) 887-5151
Village of Westfield Center
Individual Income Tax Return
For the CalendarYear of
- Filing Deadline
MAKE CHECK OR MONEY
ORDER PAYABLE TO:
Westfield Center
Income Tax
Office UseOnly
Did you live in Westfield Center all year?
Yes
No
IfNo, Move in date
W-2 Income: List Gross Income by Employer To The Right (attach W-2s)
Acct. Number
Estimated Tax Paid
(enter for part C line 2)
Move out date
Income: Business, Rents, or Professional: (Attach Federal Schedule C or E)
A TotalGross Income subjectto Westfield CenterTax
B Total Westfield Center Income Tax Due ("A" multiplied by .01)
C Credits paid on Westfield Center Income Tax:
Total
Westfield Center Income Tax Withheld
Payments on Declaration of Estimated Income Tax for
Credit from Previous Tax Year
Tax Credit for taxes paid to another city, NOT TO EXCEED 1% EACH W-2
Total
D Balance of Tax Due(must be paid with the filing ofthis return)
E If your credits (C) arelarger than your tax due (B)then enter Overpayment here
(Amountof $1.00or lessis not refundable or payable)
Use X to indicate whether overpayment is to be refunded to you• or applied against yourDeclaration of Estimated Tax•.
Declaration of Estimated Income For:
F Total Estimated Income subject to WestfieldCenter Tax
G Total Estimated Tax Due ("F" multiplied by .01)
H AmountDue with Declaration ("G" multipliedby .25)
I Less Overpaymentapplied against your Declarationof Estimated Tax
J Amount Paid with Declaration
A_
B
C_
D_
E
Amount
Amount
Amount
I hereby certify that this is a true, correct, and complete return pursuant to the Westfield Center Ordinances and Regulations.
Signed
date
Signed
date
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Parent category: Financial